Spring Panthers 2024

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Welcome! We are thrilled you are here! Thank you for considering us as part of your Spring!

Event Timing: April 2024 - July 2024

Event Address: Chilliwack Senior Turf
Juniors: Mondays 5:00pm-6:30pm
Seniors: Occasional Sundays 7:30pm-9:00pm

Athlete First Name *

Athlete Last Name *

Age And Birthdate (YYYY-MM-DD) *

Athlete Medical Number:

Jersey Size and Number.
**Jerseys are a comfortable women's cut.
Respond with 'No jersey' if you do not need a jersey. *

Fees
For Spring 2024, I understand I am paying Chilliwack Club fee separate from the FHBC insurance fee. I will be paying fees by: *

I will E-transfer to chwkpinkpanthers@gmail.com.

I will pay at the field by the third practice.

I will be writing a cheque to Chilliwack Field Hockey.

I will be paying for a uniform package as well.

I will just be paying for a jersey.

Required

Athlete Phone Number (if applicable)

Athlete Email *

Emergency Contact Name, Relation and Phone Number: *

Address *

Media Release: I agree to permit Chilliwack Field Hockey to take one or more photographs of my child to use, reproduce and/or release to others such images, whether in photographic, digital, electronic or other form without payment or compensation to me or my child.

Yes, I consent.

No, I do not consent.

Clear selection

Medical Release: In the event that an athlete is unable to provide consent during a medical emergency, consent is given to the Coach, Assistant Coach or Manager to act and sign on behalf of the athlete in their best interest.

Yes, with parent signature electronically submitted.

Clear selection

General Release: I hereby release the Chilliwack Field Hockey Club, its coaches, officers and directors from any claim in respect to any loss or injury in connection with club practices, games, tournaments, drop-ins or special trainings.

Yes, with parent signature electronically accepted.

No.

Clear selection

I understand that Field Hockey BC insurance must be paid in addition to club fees, and cannot be done by the Club. Instructions for both insurance and club fees are on the Chilliwack Field Hockey website under Fees. *

Yes

Required

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