Youth Registration Form (U18 Seniors)
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 League 2. 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 Under 18
Senior
Member
Substitute
under 18
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 members who also have
one or more parents or siblings
at the club
£22 in the first month (for England
Netball affiliation), then £11
thereafter.
£22 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 £11). 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.carolannenetball.co.uk
Membership
Secretary
Elaine Norton
07772 215499
elaine.norton@enconsultancy.co.uk
Affiliation
number (office )
Youth Registration Form (Yr 10 – Age 17)
Please fill out and return this form, together with your fees. You may email the form to
carolannenetball@gmail.co.uk or return to your junior coach. Fees can be paid by cash or cheque to
your coach or by online banking into the Carol Anne account – details on the website.
Member Details:
First name(s):
Surname:
D.O.B
Home Address:
Daytime phone:
Evening phone:
Email address (optional):
Which school or college do you attend?
Would you be interested in learning to
coach and/or umpire? (Please state)
Would you be interested in being a
committee member or other volunteer?
(Please state)
Do you have skills that could help us
develop as a club? Eg web design, admin,
bookkeeping, fundraising etc.
Parent/Carer Details:
First name(s):
Surname:
Home Address:
Daytime phone:
Evening phone:
Email address (required ):
www.carolannetnetball.co.uk
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Emergency Contacts & Medical Information (to be completed by a parent or guardian)
In case of emergency and to help us fulfil Carol Anne Netball Club’s responsibility to its
members, please 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.E
2.
2.
2.
Doctors name:
Surgery:
Doctor’s contact no:
Is your child allergic to
any medication? (Please
state)
Are they 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 ( to be completed by a parent or legal guardian):
Please read carefully and indicate your consents in the boxes.
Medical declaration: I consider my child 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 for my child. (Indicate YES or NO)
Travel: I consent to my child travelling to venues for matches and training in
transport provided by the club which may include travelling in other players’ private
cars. (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:
Relationship to member
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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