www.colwynbayhockey.com
Office use only
COLWYN BAY HOCKEY CLUB
Registration form for Members 2015/16
CBHC No:
HW No:
To be completed by applicant (or parent/guardian)
Surname:.................................................
First Name:.................................................
Male/Female:
Date of Birth:..............................................
Contact Details:
e-mail address:.............................................................................................................
Home Telephone:.....................................Mobile Telephone:.....................................
Address:.......................................................................................................................
......................................................................................................................................
For Student & U18 Members – school/college name.....................................................................................
If you wish to disclose any medical conditions that you feel the club/coaching staff need to be aware of
please give details below: e.g. Allergies, Learning Difficulties, physical difficulties etc
Players who are registered with the club are insured for 3rd party liability and serious injury cover
through Hockey Wales.
WE STRONGLY ADVISE THAT PLAYERS ALSO TAKE OUT THEIR OWN PERSONAL
ACCIDENT INSURANCE
Please circle membership type below
Membership
Type
Adult
Student
Recreational
Cost
Over 18 on 1st Sept
In full time education
£65
£40
£20
Membership
Type
Youth
Mini
Cost
Under 18 on 1st Sept
Under 13 on 1st Sept
£40
£20
As Agreed at the 2015 AGM, Senior Team Training Fees will now be collected at specific
times during the season and not at training sessions. Training Fees are £55 for the season
which should give you a saving of up to £35. These can be paid by direct debit of £20 on
1st September , £20 on 1st December and £15 on 1st February or by cheque / bank transfer
with your membership. Direct Debit Forms are available. Saturday morning training fees
of £2 will continue to be taken weekly.
Attached is my membership payment of £................... (Cheques payable to Colwyn Bay
Hockey Club) Bank Sort Code:403816, Account:21087770, Use players name as
Reference for bank transfers.
The above information will be held on Colwyn Bay Hockey Club Databases (where applicable) and will not be passed on to
other 3rd parties without member’s permission)
Please send form to: Dave Atkinson, 11, Rivieres Avenue, Colwyn Bay, LL29 7DP
Or hand to any team captain or committee member
PTO
For parents/guardians of under 16s:
I give / do not give my consent for participation, transportation (potentially in other parents or players
cars) to training & matches and photographs of my son/daughter to be taken during hockey training /
matches and that they may be used on the website, in the local press and for other club related publicity
and training.
SIGNATURE .......................................... DATE .................................
To enable the younger players to get to away matches we
particularly need drivers so you will be expected to take part in a driving rota.
(PARENT/GUARDIAN IF UNDER 16)
In order for the club to operate it is totally reliant upon volunteers to help out in a variety of ways.
This is particularly the case for parents/guardians of Youth and Mini members.
Many hockey clubs make volunteering compulsory to children’s membership; we’re not going that
far but would like to stress how important it is that parents get actively involved where they can.
If you have any particular skills such as Media experience, Grant/Funding applications, First Aid
qualification etc that you feel may be useful please put this information in the box below.
If there is a particular aspect of the club you would be interested in contributing to, such as Fund
Raising, Helping to organise Social Events, Help with Team Management or even towing the trailer
to training, then again please indicate this below as we really need volunteers.
The club would be immensely grateful for any help/expertise offered
Thanks
Name / Number :