Membership Payment Registration 2022/2023

Membership Payment Registration 2022/2023

Please fill out the following registration membership form for the 2022/2023 hockey 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 Clontarf Hockey Club. We are all looking forward to a successful and enjoyable season ahead.

Membership Type for 2022/2023 Season

Senior Membership

Club Section
Were you a member of Clontarf Hockey Club in 2021/22 season
Membership Type
Membership Type
Membership Type
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.
Do You Require Insurance. Please note insurance is only valid 7 days after registration
Members need to notify the insurance company within 60 days of the event occurring in order to make a claim (not 60 days to make a claim, just to notify them)
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 the 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. SENIOR PLAYER & PAVILION DETAILS

Name
Name
First
Last
Mobile or Landline
Mobile or Landline

Youth Membership

Club Section
Were you a member of Clontarf Hockey Club in 2021/22 season
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.
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
Total Membership Fee

SECTION A.1 YOUTH PLAYER INFORMATION

Child's Name
Child's Name
First
Last
Education
Child's Class
Child's Year
Mobile or Landline
Mobile or Landline

SECTION A.2 YOUTH PLAYER 2 INFORMATION

Child's Name
Child's Name
First
Last
Club Section
Education
Child's Class
Child's Year

SECTION B. OTHER DETAILS

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 interested in taking a coaching course?

Declaration & Payments

Please confirm the following

All players must register with Hockey Ireland

Click here for Hockey Ireland Registration Form
Registration with Hockey Ireland
Declaration
Members Data Privacy Policy
Total Membership Fee (Including Insurance if selected)

Payment - Debit/Credit Card
Start Over