Online Membership Application

Thank you for applying to join Havant Hockey Club.

Please provide us with FULL details about yourself. (for junior memberships please apply in the name of the child / children)This will then be forwarded to the Membership Secretary who will come back to you shortly. An acknowledgement of this request will also be sent back to your email address.

Note: For existing members who wish to renew their membership, please login to the website and select "My Membership".

All information provided to us will be treated in the strictest confidence.

Member Contact Information

Mandatory Fields *
Title
First Name*
Surname*
House & Street
Town / City
State / County
Country
Post Code*
Home Tel	e.g. 07777 112233
Work Tel	e.g. 07777 112233
Mobile Tel	e.g. 07777 112233
Email Address (or Parent/Guardian email - see below)*
Date of Birth*

Select Club Subsection and Membership Type

Annual subscriptions are due by the end of October each year. You will be notified later on how to set up payment.

Section that you would like to join*	Club  Mens  Womens  Mixed/AdHoc  Juniors
Training Group (For Juniors)	Vets Training  Under 8s  Under 10s  Under 12 Girls  Under 12 Boys  Under 14 Girls  Under 14 Boys  Under 16 Girls  Under 16 Boys  Under 18 Boys  Under 18 Girls
Membership Type	Minis Block A (Sep 17th 2023 to Oct 22nd 2023):   £35.00 Minis Block B (Nov 5th 2023 to Dec 17th 2023):   £40.00 Minis Block C (Jan 7th 2024 to Feb 11th 2024):   £35.00 Minis Block D (Feb 25th 2024 to Mch 24th 2024):   £30.00 Full Playing Member:   £200.00 or 8 payments of £25.00 Family Membership (1 Playing Parent and 1 Child):   £260.00 or 8 payments of £37.50 Family Membership (1 Playing Parent and 2 Children):   £320.00 or 8 payments of £40.00 Family Membership (1 Playing Parent and 3 or more Children):   £380.00 or 8 payments of £47.50 Junior Membership - 1 Child:   £140.00 or 8 payments of £17.50 Junior Membership - 2 Children:   £200.00 or 8 payments of £25.00 Junior Membership - 3 or more Children:   £300.00 or 8 payments of £37.50 Life Non Playing Member:   £230.00 Non Playing Membership:   £30.00 Non Visiting Member:   £20.00 Occasional Playing Member (<6 games):   £75.00 Full Time Student - Over 21:   £120.00 or 8 payments of £15.00 Full Time student - 18 to 21:   £0.00

Member Information

The Club needs managers, coaches and umpires. Please enter below any existing qualifications or experience. If you are interested in learning to coach, umpire or manage a team then the Club will help you obtain a qualification.

Playing experience - Please provide us with a few details about your previous playing experience.
Occupation. If student what College or University
Do you have skills that could help the Club, e.g. Coaching Qualifications, Web-design, Accounting, Planning, Sponsorship. (Please complete separate section on Sports related Qualifications)
Adult members/ Parents. Would you be interested in being a Coach, Official, Team Manager or Club officer.

Medical Details

England Hockey requires all playing Club members to complete this medical information as accurately as possible. Parent or guardian to complete for under 18 member. Access is limited to certain Club Officers only.

Do you suffer from asthma, diabetes, epilepsy, allergies or other medical condition or injury?
As far as you are aware, are you allergic to any drugs? (Please state)
Are you taking any regular medication? If so, for what reason?
If Yes to any above, please provide details*
Emergency Tel*	e.g. 07777 112233
Doctor and Surgery Address

Parental/Guardian Information - If under 18

For under 18 members we require that parents or guardians complete the following section.Please note that our Club policy requires parental consent for junior participation, transportation and photography. The Club Code of Conduct and Safeguarding and Protecting Young People in Hockey Policy are available at the Club website.

Parent/Guardian Title
Parent/Guardian First Name*
Parent/Guardian Surname*
Parent/Guardian Email*
Other Parent/Guardian Title
Other Parent/Guardian First Name*
Other Parent/Guardian Surname*
Other Parent/Guardian Email*
Photography Consent
Transport Consent

Disability

England Hockey requests the following data from clubs so that it can monitor the profile of people in clubs, can identify any under representation and can develop strategies to ensure all people have the opportunity in the future to develop and progress in sport.

Disability
Any Learning or Physical Disability*	? None Deaf Visually Impaired Hearing Impaired Physical Disability Learning Difficulty Multiple Disability ?

Thank you for taking the time to complete this form. Could we ask you to carefully read the attached terms and confirm that you are in agreement before you finalise.

I have read the attached agreement and give my consent.

Enter dice numbers to verify
that you are not a computer.

Membership Agreement

I agree to be conform with the Club Rules as published below.

Club Constitution and Rules

Club Code of Conduct

I agree to pay the above annual subscription, and for each game played, a match fee as shown in the Club fixture card and website.. This subscription includes a joining fee for Havant Sports Club which owns the Clubhouse and provides bar facilities. To use these facilities, Hockey Club members are required to join the Sports Club.

UNDER 18 MEMBER CONSENT - parent/guardian consents to following by signing Section 8 Club policy requires parental consent for junior participation, transportation and photography. The Club Code of Conduct and Safeguarding and Protecting Young People in Hockey Policy are available at the Club website.

TRANSPORTATION: I consent to my son/daughter travelling to venues for matches and training by transport provided by the Club which may include travelling in other players' or other parents' private cars.

PHOTOGRAPHY: In some environments, particularly adult competition, it is impossible to control photography by external parties and I recognise that the Club has no control of such matters. In addition, I am aware that there maybe times that photographs and/or footage maybe taken during matches and training sessions by approved agents and/or officers of the Club. Such images shall only be used for publicity/training purposes in accordance with the Club Safeguarding and Protecting Young People in Hockey Policy and Photography Policy and give consent for my son/ daughter to feature in such photos/ images. I hereby grant approved agents and officers of the Club the right to use the images resulting from the photo/film shoots. This includes any reproductions or adaptations of the images for all general purposes, e.g. local newspapers, local magazines, other promotional articles (inc. flyers) and the Club's website.

INSURANCE: The Club, its officers, volunteers, and members are insured against the risk of public liability and personal accident under its cover via England Hockey. Full details are available on the England Hockey website.

COLLEGE PARKING - when playing / training at the college I agree to park in the North car park (nearest the pitch) unless specifically advised otherwise

Under the terms of the General Data Protection Regulations (GDPR) the Club holds data about each member, as captured in this form, please use this link to review the Privacy Policy in full. This data is used for organising events and contacting members in the day to day running of the Club and may be disclosed to Club officers and other parties, as necessary, to facilitate the smooth running of the Club. Please tick the box below to confirm your agreement to this.

If at any point you believe the information we hold and process on you is incorrect you can request to see this information and have it corrected or deleted. If you wish to raise a question on how we have handled your personal data, you can contact us on dataprotection@havanthockeyclub.org.uk

Entering a confirmation tick in the consent box at the bottom of this form will be treated as a valid approval signature.