Membership Registration Form

Please fill out the following registration membership form for the 2020/2021 season. For administrative purposes, you can only register ONE member at a time. If you have any problems, please contact our secretary at secretary@clontarfhc.com

Thank you for registering with us. We are all looking forward to a successful and enjoyable season ahead.

Please Note: Membership for primary school 1st to 6th classes is now full. If you would like to add a name to the waiting list, please email junior@clontarfhc.com

 

Clontarf Hockey Club Payment Registration Form

Membership & Insurance Details

Club Section *
Were you a member of Clontarf Hockey Club in 2019/20 season *
Membership Type *
Have you already registered a Youth Member? Please only click 'Yes' if this is the second child you are paying for. There is a second child discount however, this does not apply for the first child. *
Due to current Irish Hockey Return to Play Protocol, for all away matches, a player's name and telephone number must be shared with the away club. By ticking the yes box you agree for us to share your name and telephone number. If you select no, you will not be able to be selected for away matches while this current rule is in place. This rule is subject to change and members will be informed if that is the case. *
Membership Type *
If you have already registered a Youth Member you qualify for our additional Youth Member discount. Please select below the Youth Membership Type *
Do You Require Insurance. Please note insurance is only valid 7 days after registration *
Do You Require Insurance. Please note insurance is only valid 7 days after registration *
How Would You Like To Pay? *
Direct Debit Option Only Available For Senior Membership
Standing Order Details Are As Follows:
Account name: Clontarf Hockey Club
Bank: AIB, 140 Lr Drumcondra Road, Dublin 9
Account Number: 09682003
Sort Code: 93-22-05
BIC: AIBKIE2D
IBAN: IE25AIBK93220509682003

Please make a note of the above bank details prior to submitting registration form

Please include your name as the reference when filling out the standing order form for identification purposes

Total Membership Fee (Including Insurance if selected)

SECTION A. PLAYER INFORMATION

Mobile or Landline
Mobile or Landline

SECTION A.1 JUNIOR PLAYER INFORMATION

Child's Gender *
Child's Class *
Mobile or Landline
Mobile or Landline

SECTION B. OTHER

Would you be interested in your child attending a Midterm/Summer Camp?
All senior members are expected to volunteer as a coach or umpire throughout the season. This will be randomly assigned however we will do our best to give preference to those willing to coach or umpire more regularly.
Are you willing to Coach/Umpire outside of your rostered sessions?
Would you be interested in taking an umpiring course?
Would you be interetsed in taking a coaching course?
Please confirm the following
Declaration *
Total Membership Fee (Including Insurance if selected)

Payment - Debit/Credit Card *