OSHC Member Registration Form
Welcome to the online registration form for Old Southendian Hockey Club.

The registration form is completed online. Please direct all enquires regarding membership to the Membership Secretary: Mr Mark Hopkins - Mobile: 07493 102592 - Email: markrhopkins@btinternet.com

All members of Old Southendian Hockey Club are required to complete this registration form annually and return it with payment prior to selection for the league season and/or participation in regular training sessions.

All details will be kept in a secure database with access restricted to authorised club officers only.
Section 1: Member Contact Information
Title *
Your answer
Full Name *
Your answer
Full Address *
Your answer
Postcode *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Please provide the number you will most likely respond to.
Your answer
Alternative Phone Number
Your answer
Email Address *
Your answer
Are you currently subscribed to the club bulletin / email list? *
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