YOUTH AND JUNIORS APPLICATION FORM

Please ensure that you have read and understood the Registration page 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 *
Gender *
Name *
Name
This is the child's name.
Date of birth *
Date of birth
Note the format here - MONTH FIRST!
Contact details
Primary address and numbers used for contacting the member. Normally those of the parent/guardian.
Parent/guardian name
Address
Address
If you like, you can give us details for a second emergency contact
Child protection and consents
Please enter the name of your child's doctor
Preexisting medical conditions *
Does your child have any pre-existing medical conditions that may affect their participation in hockey?
If you answered yes to the previous question, please give details, including medication, dose and frequency.
Preexisting injuries *
Does your child have any existing injuries?
If you answered yes to the previous question, please give details, including injury sustained and treatment received.
Allergies *
Does your child have any allergies?
Medical consent *
I consent to my child receiving medical treatment, including anaesthetic, which the medical professionals present consider necessary. (Please tick the box if agreed)
Transport consent *
I consent to my child being transported by persons representing the hockey club or one of its individual members for the purposes of taking part in hockey. I understand the hockey club will ask any person using a private vehicle to declare that they are properly licensed and insured and, in the case of a person who cannot so declare, will not permit that individual to transport children. (Select appropriate response)
Photo consent *
Your child may be photographed or filmed when participating in hockey events. All reasonable steps will be taken to obtain parental consent. In the absence of any explicit objection, those responsible will act in the best interests of the child which may include assuming parental agreement for the above reasons. Please indicate if you give your permission for your child to be involved in photographing/filming and for information about my child to be used for the purposes stated in Kinross Hockey Club’s Safe in Care Guidelines.
Supervision *
I acknowledge that the club is not responsible for providing adult supervision for my child except for formal junior hockey coaching, matches or competition.
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, including the code of conduct, and the decisions of the management committee.