Hucclecote Netball Club Senior Player Registration Form 2015/16
*compulsory information - PLEASE PRINT CLEARLY
*Name…………………………………………….*Home Tel’ No ………………………
*Address………………………………………………………………………………………
*Postcode………………… *Date of Birth……………… Age ………………………
*Mobile No………………………………………………… *Affiliation No ………………
*Emergency Cont’Name…………………………………*Emergency No……………
School year (if applies)……………………..*Doctor’s Tel’ No……………………
*Email …………………………………………………………………………
Please advise if you suffer from any allergies, take any medication, use an inhaler or have any
medical history which may be relevant.
Photographs and videos may be taken throughout the season for use by Hucclecote Netball Club,
local media and other netball hosting organisations. Please notify the organisers of any objections
you may have personally. I agree to abide by Hucclecote N/C Players Code of Conduct. (See website)
If you wish to share your ethnicity, religion, disability: please fill in separate sheet. Yes/No
*Signed…………………………………………………………………… Date………………………………………………………
Hucclecote Netball Club Standing Order Request Monthly Membership
To the Manager (name and address of your bank)
…………………………………………………………………………………………………
A/C No: ……………………………… Sort Code……………………………………
A/C name: ……………………………………..Player’s name……………………………………
I request that with effect from 01.10.2015 you pay the monthly payment of £28.00 to Hucclecote
Netball Club. To be taken on the 1st of every month with the last payment being taken on
01.05.2016, this being 8 payments.
A/C No: 61782436 Sort Code : 40-22-09 HSBC Bank, The Cross,Gloucester.GL1 2AP
Signed………………………………………………… Date………………………………………………………