Club Registration Form (Under 18s only) 2026/27
This form must be completed and signed by a Parent/Carer
First Name of Player
Surname of Player
Date of Birth - using following format - e.g.07/03/21
School Year in 2026/27
Address
Postcode
Full Name of Parent/Carer
Parent/Carer Contact Number
Parent/Carer email address
Name of Emergency Contact
Emergency Contact Mobile Number
Relationship to Club Member
Medical Information - ALL club members are required to provide medical information as accurately as possible. You must advise the club immediately of any changes to the information you provide.
Does the player have any long term illnesses or injuries we should be aware of?
Yes
No
If you have answered yes to above please provide details below
Please provide details of any regular medication we should be aware of:
As far as you are aware, is the player allergic to any medication?
Yes
No
If you have answered yes to above please provide details below
Please tick any Club voluntary roles which may be of interest to you / the player
Junior Coach (Monday Night)
Umpiring
Organising Fundraising/Social Events
Administration Role (e.g. fixture secretary/umpiring secretary)
N/A
Add any additional Volunteering details below
I have read and agree to the Terms & Conditions set out in the Member Declaration (U18s) on the Club Website. https://www.rhonddaladieshockeyclub.com/member-declaration
Yes
No
I confirm I have read and agree to RLHC's Policy on the Use of Photography with Young People. I give RLHC my consent to take photographic or recorded images of my child (as named above). https://www.rhonddaladieshockeyclub.com/policiesprocedures
Yes I give RLHC my consent to take photographic or recorded images of my child
No, I do not give RLHC my consent to take photographic or recorded images of my child
I have read and agree to the Terms & Conditions set out in the Privacy Policy on the Club Website. https://www.rhonddaladieshockeyclub.com/policiesprocedures
Yes
No
Signature of Parent/Carer
Date
Submit
Club Registration Form (Under 18s only) 2026/27