2017 Junior Membership Application

Junior Membership Application 2017

Southern River Hockey Club Junior Membership Application 2017
  • Please confirm school year (not age) your child is enrolled for 2017.
  • You are required to read the Juniors Playing Seniors Policy before ticking this box as additional fees may apply at a later date. Click here to be taken directly to the Policies page of the website to view the relevant documents.
  • (This information is a requirement for Hockey Australia purposes only)
  • (This information is a requirement for Hockey Australia purposes only)
  • Please provide details of any medical conditions or allergies that the Southern River Hockey Club need to be aware of. If no medical conditions, please type n/a in the box below.
  • Relationship to athlete.
  • Please enter these details carefully as this is the address that your confirmation email will be sent to.
  • This is the person we need to contact in a medical emergency.
  • Please indicate your interest if you are able to support the Club in any of the above roles.
  • JUNIOR HOCKEY PLAYER CODE OF CONDUCT

    At hockey training, games and socially:

    I will learn the rules of hockey and play by them
    I will always act responsibly to avoid injury to myself and others
    I will NEVER argue with an umpire
    I will be a good sport and will not lose my temper or show physical aggression
    I will respect my coach and organisers and the time and effort they give
    I will always encourage all other members of the team
    I will applaud all good plays whether they are made by my team or the opposition.
    I will be a team player
    I will accept the fact that at certain time I must be a substitute
    I will respect all playing equipment
    I will regularly attend training
    I will be on time for training and games
    I will wear our complete uniform with pride
    I will try to watch higher grades to learn more

    AS A PARENT OF A HOCKEY PLAYER:

    I will assure that my child follows the Junior Hockey Player Codes outlined above
    I will NEVER argue with an umpire, coach or other parents in my child’s team
    I will be a good sport and will not lose my temper or show physical aggression
    I will not interfere or talk with coaches while the game is in progress
    I will pay all fees by the due date
    I will participate in fundraising activities

    JUNIOR SELECTION POLICY

    The Junior Selection Policy can be viewed on the Club website. Click here to be taken directly to the Policies page of the website to view the relevant document/s.

    PLAYER RISK

    I acknowledge that there are risks involved in playing hockey and agree to indemnify the Southern River Hockey Club and The Western Australian Hockey Association Inc. and/or their volunteers and employees and save them harmless and free from liability for any injury or loss suffered by me or my child/children arising out of any activity involving my child and the Club and/or the Western Australian Hockey Association Inc. I also confirm that my child is physically and mentally capable to undertake hockey. If your child has a medical condition, please attach a medical certificate.

    PLAYER INSURANCE

    I acknowledge that the Southern River Hockey Club has taken out a Player Injury Insurance policy cover for my child with the Hockey Australia National Group Insurance Plan managed by JLT Sport and placed with underwriter Sportscover Australia (full details available at www.hockeywa.org.au). This is a base cover only. This base cover can be topped up individually for any player at a very reasonable premium cost through Hockey WA’s website, which is highly recommended where private health cover and/or dental excess is not held. This top up of cover service is available interactively in one on-line session.

    PRIVACY COLLECTION STATEMENT (HOCKEYNET SPECIFIC)

    Hockey Australia (HA) requires the compulsory information requested for use in relation to HockeyNet. Any personal information provided will only be used in accordance with the objects and purposes of HA, HA general business and in relation to HockeyNet. If the requested personal information is not provided, you may not be able to receive the benefits of registration with the HockeyNet system. Individuals will be able to access their personal information through HA upon reasonable notice. For further information on Hockey Australia’s Privacy Policy refer to www.hockey.org.au.

    UN-FINANCIAL PLAYERS

    All junior fees due are to be paid in full/or a direct debit agreement signed by 31st May 2017 in order to remain financial. If no fees have been paid or direct debit arrangement made by this date you will be deemed “unfinancial” and will not be covered by player insurance. If you are having trouble paying your fees please contact the Treasurer to discuss a payment plan.

    Any player that is deemed un-financial by the Treasurer will be ineligible to participate in ANY HWA junior (or senior) fixtured game for 2017 (including but not limited to finals) and will also be ineligible for any end of season awards.
  • Please select the relevant fee rate from the drop down menu below.

    When selecting the fee type below you are also acknowledging that you accept the clubs Refund Policy which is available for viewing here.

    Discounts apply to:
    – the 3rd registered child from the same family receives a 10% discount
    – the 4th and any subsequent child from the same family receives a 20% discount
    – discounts apply in order from oldest to youngest child in the same family
  • Please indicate how you will be paying your 2017 fees.
  • $ 0.00
  • This field is for validation purposes and should be left unchanged.