HOLROYD HOTSHOTS NETBALL CLUB – REGISTRATION 2015
MEMBER DETAILS - Please complete ALL details, print clearly [names will appear on scoresheet and end of year awards]
Individual / Family
Member 1
Member 2 (3 or more members residing at same address, pls complete family discount
form)
FIRST NAME
LAST NAME
DATE OF BIRTH
MOBILE
EMAIL*
HOME ADDRESS
HOME PHONE
PARENT’S NAME (if <18yrs)
LAST PLAYING DETAILS
Age/Grade/Assoc/Year/Final Placing
Age/Grade/
Assoc/Year/
Final Placing
Do you have:
□ Aboriginal/TSI background?
□ Aboriginal/TSI background?
REGISTRATION CATEGORY
□ Non-English speaking background? □ a disability?
□ Junior - $115 (1o-15yr); $75 (8-9); $55 (5-7)
□ Senior - $115 (16-17yr)
□ Senior - $145 (18+yr)
□ Non-player - $45
□ Non-English speaking background? □ a disability?
□ Junior - $115 (1o-17yr); $75 (8-9); $55 (5-7)
□ Senior - $115 (16-17yr)
□ Senior - $145 (18+yr)
□ Non-player - $45
□ A-line dress, size____ $80
□ A-line dress, size____ $80
□ Club shirt, size ____ $35* (optional)
□ Club shirt, size ____ $35* (optional)
□ Club hoodie, size ____ $45* (optional)
□ Club hoodie, size ____ $45* (optional)
□ Sock order: □ Anklet, size _____ $10* OR □ Calf, size ______ $10*
□ Sock order: □ Anklet, size _____ $10* OR □ Calf, size ______ $10*
□ Not required *price subject to change upon ordering with stockists in 2015
□ Not required *price subject to change upon ordering with stockists in 2015
TOTAL COST OF REGISTRATION*
$
+ total of family discount form (if completed)
Note: no pay – no play (full payment must be made by Rd 7)
INVOLVEMENT - Holroyd Hotshots Netball Club is run solely by volunteers. Senior players are requested to complete umpiring duty through the season or pay the nominal fee and be available
for Canteen or Ground Duty. Parent assistance will be called upon for Canteen Duty and Ground Duty, by registering your child you are agreeing to complete one duty per season.
UNIFORM
(please tick)
AGREEMENT
I agree to abide by the Constitution of Holroyd Hotshots Netball Club and that of Parramatta Auburn Netball Association Inc. I agree to abide by the Code of Conduct for players, officials and
spectators.
Signature: _______________________________________
(<18years - Parent/Guardian)
Date: ________________________
PAYMENT OPTIONS
CLUB USE ONLY
□ Cheque payable to HOLROYD HOTSHOTS NETBALL CLUB
Date Paid:
Amt Paid:
□ Cash
Method of Payment: Cash / Cheque / Direct Debit
□ Direct deposit to: Holroyd Hotshots Netball Club
Receipt No.
Balance Owing:
Select Mutual Banking BSB: 802-091 Account: 509628 Ref: your family name/surname
*if you do not wish to receive netball news and updates from Netball NSW and/or Netball Australia, please tick this box □
HOLROYD HOTSHOTS NETBALL CLUB – NSW NETBALL DISCLAIMER 2015
Disclaimer
1. If Member is 18 years of age or older
By signing this form, I agree to abide by the Association’s Constitution and By Laws, Codes of Behaviour, Member Protection Policy, Sports Injury Insurance Policy
(contact the Association to view these documents). I am aware of the risks of playing netball whilst pregnant. I am aware of the risks of playing netball with a preexisting medical condition.
Member Signature: ____________________________________________________________________________________
2. If Member is under 18 years of age
As the Parent/Guardian signing this form on behalf of the Member, I agree to abide by the Association’s Constitution and By Laws, Codes of Behaviour, Member
Protection Policy, Sports Injury Insurance Policy (contact the Association to view these documents). I am aware of the risks of playing netball with a pre-existing
medical condition.
Parent/Guardian Signature:_______________________________________________________________________________
Parent/Guardian Name:_______________________________________________________________________________
Netball NSW Privacy Policy
1. It is the policy of the NSW Netball Association Ltd to comply with the Privacy Act. Personal information about you is only obtained from information provided
by you. This data is collected by NSW District Associations affiliated with Netball NSW. Members can change or gain access to their personal information by
contacting their District Association or by contacting Netball NSW, PO Box 396, Lidcombe NSW 1825, Tel: 02 9951 5000, Fax: 02 9951 5099, email:
[email protected]
2. Member Information is collected for the following purposes:
a) Statistics:
Personal information in an aggregated format is collated to produce statistics that is supplied to government agencies as required. The
information is used by Netball NSW for research, developing and managing new and existing programs, for strategic and planning purposes and for the
promotion of netball in NSW. An individual’s personal information is not identifiable or provided in this data.
b) Administration & Information
Personal information may be used for communicating and providing information to participants about their membership and/or their involvement
in programs, competitions, including those of sponsors and other general netball activities. Any member can request not to receive mail communications
that do not directly relate to their participation in programs or their membership.
3. Disclosure of Membership Information
Netball NSW may facilitate aggregate database access for Netball Australia, sponsors and other relevant interested parties to enable these bodies the
opportunity to have mail outs forwarded to members. In such cases member’s personal contact information is not provided. Third parties, such as mailing
houses, may on the signing of a confidentiality agreement, obtain a copy of aggregate data.
4. ‘Opt In/Out’
Netball NSW provides all members the opportunity to ‘opt in’ of any direct communication with the organisation. Further to this members are provided with an
‘opt out’ clause at the time of communication.
Further information about the Netball NSW Membership Privacy Policy is available from your affiliated Association or alternatively from Netball NSW.
Netball NSW Refund Policy
It is the policy of the NSW Netball Association Ltd that subsequent to receipt of Netball NSW registration fees and the input of player registration data into the
NMAS membership system refunds are not provided.
NOTE: Please ensure that all details on this form are correct prior to signing & returning to your club coordinator.
HOLROYD HOTSHOTS NETBALL CLUB – FAMILY DISCOUNT FORM 2015
TO COMPLETE: 3 or more members residing at the same address (family discount applies)
MEMBER DETAILS - Please complete ALL details, print clearly [names will appear on scoresheet and end of year awards]
Member 3
Member 4
FIRST NAME
LAST NAME
DATE OF BIRTH
MOBILE
EMAIL*
HOME ADDRESS
family discount applies to members residing at the same address
HOME PHONE
PARENT’S NAME (if <18yrs)
LAST PLAYING DETAILS
Age/Grade
Age/Grade
Assoc
Assoc
Year
Year
Final place
Final place
Do you have:
□ Aboriginal/TSI background?
□ Aboriginal/TSI background?
REGISTRATION CATEGORY
UNIFORM
(please tick)
TOTAL COST
□ Non-English speaking background? □ a disability?
□ Junior - $90 (1o-15yr); $60 (8-9); $40 (5-7)
□ Senior - $90 (16-17yr)
□ Senior - $115 (18+yr)
□ Non-player - $45
□ Non-English speaking background? □ a disability?
□ Junior - $30 (1o-17yr); $30 (8-9); $30 (5-7)
□ Senior - $30 (16-17yr)
□ Senior - $40 (18+yr)
□ Non-player - $45
□ A-line dress, size____ $80
□ Club shirt, size ____ $35* (optional)
□ Club hoodie, size ____ $45* (optional)
□ Sock order: □ Anklet, size _____ $10* OR □ Calf, size ______ $10*
□ Not required *price subject to change upon ordering with stockists in 2015
$ (please add to total registration cost on first page)
□ A-line dress, size____ $80
□ Club shirt, size ____ $35* (optional)
□ Club hoodie, size ____ $45* (optional)
□ Sock order: □ Anklet, size _____ $10* OR □ Calf, size ______ $10*
□ Not required *price subject to change upon ordering with stockists in 2015
*if you do not wish to receive netball news and updates from Netball NSW and/or Netball Australia, please tick this box □