Coaches
Claire O Regan 087-9022663
Liz Hassett 087-7693293
Joanne O Reilly 086-2283047
Please complete the enclosed Membership form and bring it, along with the appropriate registration fee on the 5th September 2010. If you were member last year there is no need to complete a form unless your details have changed or you are registering a new member.
We Look forward to seeing you then,
Regards,
Claire O Regan.
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Volunteers Form
Name: _______________________
Contact details: (telephone. no or email address) __________________________________________________________ Yes No
I am available to help out at training:
_______________________________________________________
I am available to help out at matches:
_______________________________________________________
You can include my details on a volunteers
coaching rota:
_______________________________________________
North Kildare Hockey
Junior Membership Registration Form
Today’s Date:_______________ Section: _______________
Total Fee Due:______________
Member Details:
Surname:______________________ First Name:_____________________
Date of Birth: __________________
Address: ______________________________
______________________________
_______________________________
Are you a member of any other section of the club?
If yes then please circle one of the following: Rugby / Cricket / Tennis
Parent/Guardians Name: 1._______________________________________
2._______________________________________
Contact details:
Home phone number: ______________________________________
Mobile No. 1.______________________ 2._________________________
Email address:__________________________________________________
Does your child have any medical condition that we should be aware of?
Is your child on any medication, or do they have any allergies? Yes / No
If you answered yes to any of the above please give details below.
___________________________________________________________________________________________________________________________________________________________________________________________________
Date of Membership acceptance :_________________
Signature of Club Officer:___________________________