Senior Registration Form (Age 18 and above)
Welcome to Carol Anne Netball Club!
Carol Anne Netball Club is a thriving club with 11 senior teams and 5 junior sections.
Seniors play in the North Devon Netball League, the East Devon County League and the
South West Regional 2 League. NDNL senior matches are Monday nights 6.55pm or 8.20pm
at Park School, Barnstaple. Carol Anne training sessions are also at Park School on Tuesday
evenings, please see the website for a downloadable training sheet and fixtures.
Joining:
Senior members can train and play free for 3 weeks but thereafter must be registered with
the club and affiliated to England Netball (for insurance purposes) by returning the attached
form and paying the fees.
By returning this form you are confirming that you have read and agree to the
club rules, codes of conduct and constitution. You can find all these on the club
website : www.carolannenetball.co.uk .
Fees:
You must also set up your Standing Order for the fees. The fees for 2012/13 are as follows:
Full Member
Substitute
Member
Family
Member
All training and winter match
fees, use of kit, use of courts,
coaching, EN affiliation etc
For those only playing
occasionally, not a full member
of a team
For senior members who also
have one or more children at
the club aged under 21
£30 in the first month (for England
Netball affiliation), then £12
thereafter.
£30 in the first month then £2 per
match and £2 per training session
Please ask for details
The fees include your England Netball affiliation which you must have for insurance
purposes. Each August you must re-affiliate and will be asked that month for a top-up fee
(in 2012 this was £18). Full members also receive Carol Anne match kit but this
remains the property of the club and must be returned if you no longer play in
matches. You can find Standing Order instructions on the website.
Club contact details:
Head Coach & Chair
Secretary & Web
Vice Chair
Sally King – 077779049015 sally.e.king@hotmail.co.uk
Elaine Norton – 07772215499 elaine.norton@enconsultancy.co.uk
Laura Manley – 07810355039 alanalucasmummy@yahoo.co.uk
www.carolannetnetball.co.uk
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Membership
Secretary
Elaine Norton
07772 215499
elaine.norton@enconsultancy.co.uk
Affiliation
number (office
use)
Senior Registration Form (Age 18 and above)
Please fill out and return this and the following two pages. You may email the form to
carolannenetball@gmail.co.uk or return by hand to your coach. To complete the
registration you must also set up your Standing Order pay your fees–details are on
the website: www.carolannenetball.co.uk. We will then be able to make your England
Netball affiliation, without which you cannot play or train beyond the first three weeks (which
are covered by the club’s insurance)
Member Details:
Title:
First name(s):
Surname:
DOB:
Daytime phone (required):
Evening phone (required):
Email address (required):
Home Address:
Member Information (for club development purposes):
Students only: what school, college or
university do you attend?
Non students: What is your occupation?
Would you be interested in learning to
coach and/or umpire? (Please state)
Would you be interested in being a
team manager, committee member or
officer? (Please state)
What skills do you have that could help
us develop as a club, eg web design,
accountancy, paper printing, news etc.
www.carolannetnetball.co.uk
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Emergency Contacts and Medical Information (
In case of emergency and as part of Carol Anne Netball Club’s responsibility to its members,
ALL members must complete this medical and emergency contact information as accurately
as possible. Details are held securely with access restricted to authorised members only.
Emergency contacts:
1.
Relationship:
1.
Contact numbers:
1.
2.
2.
2.
Doctors name:
Surgery:
Doctor’s contact no:
Are you allergic to any
medication? (Please state)
Are you taking any
regular medication? If
so, for what reason?
Please state any long
term illnesses, injuries or
physical or learning
impairments that we
should be aware of.
Declaration and Consents:
Please read carefully and indicate your consents in the boxes.
Medical declaration: I consider myself to be physically fit and capable of full
participation, and agree to notify Carol Anne Netball Club of any changes to the
medical information provided. (Indicate YES or NO)
Medical consent: In the event of an injury, I give my permission for the team
managers/coaches/first aiders appointed by Carol Anne Netball Club to obtain
emergency medical treatment on my behalf. (Indicate YES or NO)
Photography: Where the club authorises photographs and videos by approved
agents I consent to its use in accordance with Safeguarding and Protecting Young
People policies and the Photography Policy including for local newspapers, promotional
articles and the club website. (Indicate YES or NO)
Signed:
Date:
Please also print name:
Now please complete the additional, optional information for club development purposes on
the next page.
www.carolannetnetball.co.uk
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For club development purposes only
Optional Member Information
Please indicate YES as appropriate:
White British
Asian or Asian British Pakistani
Asian or Asian British –
Bangladeshi
Asian or Asian British – Other
Black or Black British –
Caribbean
Black or Black British –
African
Black or Black British – Other
Chinese
Other Ethnic Group (State)
White Irish
White Other
Mixed – White and Black
Caribbean
Mixed – White and Black
African
Mixed – White and Asian
Mixed – Other
Asian or Asian British - Indian
Please indicate YES as appropriate:
Deaf
Visually impaired
Hearing impaired
Physical disability
Learning disability
Multiple disability
Please use this space to tell us any additional information:
www.carolannetnetball.co.uk
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