ADULT MEMBERSHIP 2021-2022

We are so pleased that you are joining us at Southgate Hockey Club this coming season!

The subscription for the 2021/2022 Season covers:

• Your annual joining fee.
• All match fees and teas throughout the season.
• All coaching, training and pitch hire throughout the season.
• All Affiliation and League Fees.
• 5% Discount and other Member promotions at the bar in our clubhouse.
• This year we are pleased to add GDN Strength & Conditioning online classes (live and on demand) as an added benefit of membership at Southgate Hockey Club.

** Fees paid after the 15th of October 2021 will be considered as late and will incur a 20% Penalty Fee. PLEASE PAY YOUR SUBS ON TIME.

Please fill in the below membership form and then you will be directed to the relevant payment page:

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.

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.

Click here if you would like to sign up to our weekly Newsletter and be the first to hear about Southgate News, Events, Matches, Socials and MORE throughout the 2021-2022 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.