Clontarf Hockey Club Junior Payment Registration Form

Membership Details

Club Section *
Were you a member of Clontarf Hockey Club in 2020/21 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

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

SECTION B. OTHER

Would you be interested in your child attending a Midterm/Summer Camp?
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

Payment - Debit/Credit Card *