Hockey Camp Easter 2019
Please complete the following questions. Provide as much additional information as you wish.
If you have any questions please email me at clydesdalehockey@btconnect.com.
When you have completed the form successfully an on screen confirmation will appear. We will not normally follow up with an email until nearer the start of the camp.
Payment of £95 per child can be made by cheque, cash or BACS. Please ask for bank details if you wish to pay by BACS.
David
Email address *
Players Forename *
Your answer
Players Family Name *
Your answer
Players Gender *
Address *
Your answer
Post Code *
Your answer
Home Phone Number *
Your answer
Business Phone Number
Your answer
Mobile Phone Number *
Your answer
Please advise school year *
Date of Birth *
DD,MM,YYYY - Please change year from default of 2018
MM
/
DD
/
YYYY
Name of Parent/Guardian *
Your answer
Relationship to Child *
Address of Parent/Guardian (if different)
Your answer
Post Code of Parent/Guardian if different
Your answer
Emergency Contact Name if different from Parent/Guardian
Your answer
Phone Number of Alternative Contact
Your answer
Relationship of Alternative Contact to Child
Your answer
Do you consent to the club taking photographs/videos in line with club policy for coaching and promotion?
Yes
No
I consent
Child's Doctor *
Your answer
Doctor's Address
Your answer
Doctor's Phone Number *
Your answer
Does the child have a Disability *
If yes please give details
Your answer
Does your child currently take any medication *
If yes, please provide details of medication
Your answer
Can your child self- administer their required medication
Your answer
Does your child suffer from any allergies *
If yes please provide details of the type of allergy and the medication used to control the allergy
Your answer
Any other relevant information about your child which you as the parent / guardian would like to make Clydesdale Hockey Club aware of *
If yes please provide details
Your answer
Can my child leave the club grounds for lunch *
Please advise age size for T shirt *
Please confirm you agree to terms stated by Clydesdale Hockey Club. When you click on Submit you will receive an on screen comfirmation of acceptance screen. *
A copy of your responses will be emailed to the address you provided.
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