2020/2021 SUBS PAYMENT COMPLETE

 Thank you for completing / setting up your payment for your subs for the coming 2020/2021 season.

Please ensure you complete the below membership form to ensure we have you on record and to confirm you have signed up to the England Hockey Player Participation Agreement and the Southgate HC Code of Conduct.

MEMBERSHIP FORM 20/21

All members of Southgate Hockey Club are required to complete this registration form and return it with payment prior to selection for the league season.  This information will be used to keep you informed about Club events and to contact you in the event of an accident or incident.  Some of the information is required to comply with the England Hockey Equality Policy, which has been adopted by the Club. In line with GDPR, all details will be kept secure with access restricted to authorized club officers only.

Club Membership

First Name *

Surname *

Email Address *

Mobile No

Date of Birth (dd/mm/yyyy) *

Required for data collection by England Hockey

Please let us know if you have any medical conditions we need to be aware of. *

Gender * Male Female

Required for data collection by England Hockey and Club statistics.

Occupation

Not Required however useful to understand our club membership to help in possible development and support in the future.

Emergency Contact Name *

Required in case of emergency

Emergency Contact Number *

Required in case of emergency

Ethnicity of Club Members * White British White Irish White Other Mixed – White and Black Caribbean Mixed – White and black African Mixed – White and Asian Mixed – Other Asian or Asian British – Indian Asian or Asian British – Pakistani Asian or Asian British – Bangladeshi Asian or Asian British – Other Black or Black British - Caribbean Black of Black British – African Black or Black British – Other Chinese Other Ethnic Group Prefer Not to Say

Required for Data Collection by England Hockey and to monitor Southgate HCs Diversity & Inclusion Policy

Membership Category * Adult Full Membership Adult Goal Keeper Full Membership Junior Playing Adult Hockey Junior Goal Keeper Playing Adult Hockey 1st Year Graduate / Student 1st Year Graduate / Student Goal Keeper 10 Match Adult 10 Match 1st Year Graduate / Student Non Playing Membership Training Only Life Member

Southgate HC - Code of Conduct - Declaration *

I agree to abide by the Southgate Hockey Club Rules and the Code of Conduct which are available on the club website.

England Hockey - Player Participation Form - Declaration *

I have filled in the England Hockey Player Participation Form and in turn agree to abide by all COVID-19 rules and regulations to ensure a safe playing environment for myself and others

Southgate HC - Membership Card *

I am happy for my Name, DOB & Email to be passed on to Centre Administration so that I can receive my membership card.

A Southgate Hockey Centre Membership Card will be issued to each player which will entitle you to members rates at the bar. Your Name, DOB & Email will be passed to the Centre Administration so cards can be issued. This information will be used for identification only and is managed within the GDPR Guidelines.

Please select below if you would like to be kept in contact with all of our News, Match Reports, Events etc throughout the 2019-2020 Season. *

Yes! Please keep me updated with ALL the news about Southgate Hockey Club

No thank you, I do not want to be kept up to date with what is happening at the club.

Signature *

Please write name here to confirm details are correct.

If you are human, leave this field blank.