ADULTS APPLICATION FORM

Please ensure that you have read and understood the Registration page, the Data Protection Policy and the Code of Conduct before completing this form.

We need you to you complete this form at the start of every season and to let us know as soon as possible if any of the information changes. All information will be treated with sensitivity, respect and will only be shared with those who need to know e.g. a team manager or first aider, or Scottish Hockey.

Introduction

Membership type

Full

Youth

Social

Korinthians

Official

Non-playing

Gender

Male

Female

Name

First Name

Last Name

Date of birth

NOTE: MONTH FIRST!!

YYYY

Contact details

Email Address

Mobile number

Landline

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Qualifications

Coaching qualifications

PVG cleared

(Protection of Vulnerable Groups - i.e. cleared to coach children etc)

First aid qualifications

Umpire qualifications

Emergency information

Emergency contact name

Relationship to applicant

Emergency contact telephone

2nd emergency contact

Optional

2nd emergency contact name

2nd EC Relationship to applicant

2nd EC Telephone

Medical conditions

If you suffer from a preexisting medical condition, you may like to give us details here. This information will be retained with first-aid kits in case of emergencies. Completion of this field is optional.

Completion

In the absence of a paper form, by clicking the "Submit" button below you are making a formal application to join Kinross Hockey Club. You confirm that you have read and understood all of the terms and conditions involved and agree to be bound by the rules of the club and the decisions of the management committee.

Form

ADULTS APPLICATION FORM