Player Registration Form

All prospective members of Llanfair Hockey Club are required to complete this registration form. All details will be kept in a secure database with access restricted to authorised officers only.

2025/26 Membership: Deadline for payment is 30th September, after which an additional £5 admin fee will be due.

You may be eligible for £5 deduction on our membership fees for other siblings after payment of your membership fees in full.

Senior - Aged 18+ playing regularly - £65
Junior 13-17 as at 1st September 2025 - £50
Junior 7-12 as at 1st September 2025 - £40

Contact Details

Title

Forename(s)

Surname

Date of Birth

Address

Mobile Number

Membership Details

Please make cheques payable to ‘Llanfair Hockey Club’ or if you would like to pay online the bank details are:

Account name: Llanfair Hockey Club
Sort code: 53-81-00
Account number: 22602925

Please put the member’s name as the reference, and if paying for a junior member please confirm with the club that you have paid online.

In a change to previous years, you will now join Hockey Wales directly through your unique Sport80 Member platform.

Simply log onto your Sport80 platform and click on the RENEW MEMBERSHIP button. Alternatively, if you cant log onto your member platform, please contact Hockey Wales.

I agree to pay the appropriate Hockey Wales fees directly to them

Medical Information and Consent

In case of emergency and as part of Llanfair Hockey Clubs responsibility to its membership, ALL members are required to complete this medical information form as accurately as possible. Details will be held securely with access restricted to authorised officers only.

Next of Kin

Relationship

Mobile No.

Drs Name

GP Surgery

Contact No.

As far as you are aware, are you allergic to any medication? (Please state)

Are you taking any regular medication? If so, for what reason?

Do you have any long term illnesses or injuries?

DECLARATION: I consider that the above person is physically fit and capable of full participation and agree to notify the Llanfair Hockey Club of any changes to the medical information provided. Furthermore, in the event of injury I give my permission for the team managers/coaches appointed by Llanfair Hockey Club to obtain and provide emergency medical treatment to the above person.

I agree to the above

Signed by

Under 18 Member consent - to be completed by PARENT or LEGAL GUARDIAN

It is a requirement of Llanfair Hockey Club policy that parental/legal guardian consent is provided for participation, transportation and photography. The Llanfair Hockey Club Members Code of Conduct and Safeguarding and Protecting Young People Policy are available in the handbook.

TRANSPORTATION: I consent to above person travelling to venues for matches and training, in transport provided by the club, which may include travelling in other players’ private cars, if/when Covid guidance allows.

PHOTOGRAPHY: In some environments, particularly adult competition it is impossible to control photography by external parties. However, I am aware that there may be times that photographs and/or footage may be taken during matches and training sessions by approved agents and/or officers of Llanfair Hockey Club. Such images shall only be used for publicity/training purposes in accordance with Llanfair Hockey Clubs Safeguarding and Protecting Young People Policy and Photography Policy and I give consent for the above person to feature in such photos/images. I hereby only grant approved agents the right to use the images resulting from the photo/film shoots. This includes any reproductions or adaptations of the images for all general purposes, e.g. local newspapers, local magazines, other promotional articles (including flyers) and the club’s website.

Signed by

Relationship