Junior Player Registration Form 2021
Welcome to the 2021 Hockey Season

It is a requirement by Hockey New Zealand and Wellington Hockey that everyone is to register.

Please fill out the form below to register – credit card payments will not be available – see below for the available payment methods.

2021 Subs - $120.

Payment can be by cash, cheque or internet payment as long as it is paid in FULL by 31 MAY 2021. Subs can still be paid by automatic payment. A payment plan needs to be confirmed with the Treasurer. Paying by any of these methods is not part of the registration process.

It is preferable if Junior subs are paid prior to the child taking the field.

Our account number is ANZ, Upper Hutt, 06 0773 0025162 00, use your name as a reference.

Any questions please email upperhutthockey@gmail.com
First name *
Last Name *
Parent Caregiver First Name *
Parent Caregiver Last Name *
Address Line 1 *
Address Line 2 *
City *
Email *
Phone - Home *
Phone - Cell *
Emergency Contact *
Emergency Contact Phone *
Date of Birth *
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/
DD
/
YYYY
Current School Year Level 2021 *
Gender *
Club Played for 2020 *
Grade registered in 2020 *
I acknowledge that images captured during games involving my child may be used for club promotional purposes *
I wish to opt out of fundraising, and instead pay an additional $40 (which will be invoiced as part of subs) *
Do you wish to receive general correspondence by email? *
Do you require a transfer from another club? *
Submit
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