Falmouth Hockey Club Membership Form

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Welcome to Falmouth Hockey Club

Facebook - Falmouth Hockey
Instagram - @falmouthhockeyclub

All prospective members of Falmouth Hockey Club are required to complete this registration form and return it with payment prior to selection for the league season. All details will be kept in a secure database with access restricted to authorised club officers only.

CONFIDENTIALITY: The information given below will be maintained on the club’s data base to which no unauthorised person shall have access and will be subject to strict control under the General Data Protection (GDPR) Regulations 2018.

Please can parents of U18's fill out on behalf of and with their child.

Email *

SECTION 1: MEMBER CONTACT INFORMATION

For Club purposes only.

Title *

Miss

Mrs

Other:

First Name *

Surname *

Address and Post Code *

Date of Birth *

YYYY

Contact Telephone Number *

Contact Telephone number and name in case of Emergency on Match / training Days (next of kin) *

Playing number on shirt (if you have been allocated one)

SECTION 2: MEMBERSHIP TYPE

Please contact our treasurer for any questions regarding subs.

PLEASE PAY SUBS BY 1ST OCTOBER OF EACH SEASON, the club can enforce a 'no pay, no play' policy after this point.

Falmouth Hockey Club
Sort Code 30-98-57
Acc No. 00230927

Member Type *

£120 full senior

£80 student

£80 junior

Social Subs £10

SECTION 3: MEMBERSHIP INFORMATION

(Information in this section is optional and will be used for club development purposes only)

Which team/squad do you currently belong

1st XI

2nd XI

3rd XI

4th XI

Mens 1XI

U16

U14

U12

U10

Other:

Clear selection

STUDENTS – What school/college or university do you attend?

NON-STUDENTS – What is your occupation?

Would you be interested in learning to coach and or umpire?

Yes

Maybe

Other:

Clear selection

Would you be interested in being a team manager or club officer?

Yes

Maybe

Other:

Clear selection

What skills do you have that could help develop the club? (e.g. web design, accounting, printing, planning, sponsorship, etc)

I / my parents follow the clubs social media page(s).

Facebook - Falmouth Hockey

Instagram - @falmouthhockeyclub

SECTION 4: MEDICAL INFORMATION & CONSENT

To be completed by PARENT or GUARDIAN if under 18
In case of emergency and as part of the club's responsibility to its membership, ALL club members are required to complete this medical information form as accurately as possible. Details will be held securely with access restricted to authorised club officers only.

Next of Kin *

Relationship to Member *

Contact telephone number / numbers *

Doctors Name and Surgery Address *

As far as you are aware, are you allergic to any medication? (Please state) *

Are you taking any regular medication? If so, for what reason? *

Do you have any long term illnesses, allergies or injuries? *

Declaration: I consider myself (my son/daughter) to be physically fit and capable of full participation and agree to notify the club of any changes to the medical information provided. Furthermore, in the event that I am injured I give my permission (for my son/daughter)* for the team managers/coaches appointed by Falmouth HC to obtain emergency medical treatment on my behalf. *

Yes

SECTION 5: UNDER 18 MEMBER CONSENT (**TO BE COMPLETED BY PARENT/GUARDIAN**)

This is to be completed by the parent/legal guardian of a young person under the age of 18. Separate forms need to be completed for each young person. In accordance with England Hockey’s Safeguarding Policy, Falmouth Hockey Club does not permit photographs or video content of young people to be taken without the consent of parents/carers and the young person. To ensure young people enjoy hockey in a safe and enjoyable environment, we will follow England Hockey’s 'Taking and Using Photographic/Recorded Images of Young People' Guidance.

Please select below. *

I do consent to Falmouth Hockey Club taking photographic or recorded images of my child and for these to be used on our club social media, website and local paper to celebrate success.

I do NOT consent to Falmouth Hockey Club taking photographic or recorded images of my child and for these to be used on our club social media, website and local paper to celebrate success.

N/A

Photography consent for Club members over 18 *

I do consent to Falmouth Hockey Club taking photographic or recorded images of me and for these to be used on our club social media, website and local paper to celebrate success.

I do NOT consent to Falmouth Hockey Club taking photographic or recorded images of me and for these to be used on our club social media, website and local paper to celebrate success.

N/A

Club Welfare Officer - Lesly Heather *

I am aware that the club welfare officer is Lesly Heather and I can contact her via leslyheather@gmail.com / 07813130073 If I have any safeguarding concerns or I feel myself or a young person is at risk.

Lesly Heather - Club Welfare Officer

SECTION 6: POLICY AND GOOD PRACTICE

Falmouth Hockey Club strives to create a safe and enjoyable environment for all. By joining our club, you agree to follow policies and procedures put in place by England hockey in regards to photography, ethics, conduct, anti-bullying, safeguarding, equality, diversity and inclusion. All of which can be found here.

http://www.englandhockey.co.uk/landing.asp?section=2481&sectionTitle=Inclusion%2C+Diversity+%26+Compliance

Any one found to be in breach of these will be contacted by our Club Disciplinary officer.

WhatsApp Good Practice - please read

I have read the WhatsApp Good Practice guidance and agree to keep any content appropriate when communicating on hockey groups and social media. *

Yes

I have read the England Hockey Generic Code of Behaviour below and agree to conduct myself in accordance to the clubs ethos, as outlined by England Hockey here. http://www.englandhockey.co.uk/page.asp?section=2482&sectionTitle=Code+Of+Ethics+%26+Behaviour *

Yes

England Hockey Generic Code of Behaviour - Please read.

Definitions

• Equality in Sport
This is about fairness, equality of access, recognising inequalities and taking steps to address them. It is about evolving the culture of hockey to ensure that it is equally accessible to all members of society.
• Sports Equality
This is about an individuals and organisations responsibility to challenge discriminatory practice and promote inclusion.
• Direct Discrimination
Direct Discrimination is defined as treating a person less favourably than others would be treated in the same circumstances
• Being Equal
Treating individuals equally is not necessarily the equivalent of treating them the same. In some cases the need for equality may require unequal effort to ensure the principal is achieved.
• Indirect Discrimination
Indirect discrimination is when there’s a practice, policy or rule which applies to everyone in the same way, but it has a worse effect on some people than others. The Equality Act says it puts you at a particular disadvantage.
• Harassment
Harassment can be described as inappropriate actions, behaviour, comments or physical contact that are objectionable or cause offence to the recipient. It may be directed towards people because of their age, sexuality, disability or some other characteristic.
• Victimisation
This is defined as when someone is treated less favourably than others because he or she, acting in good faith, has made an earlier complaint of unlawful discrimination against or to Falmouth Hockey Club under one of the relevant acts/regulations or provided information about inappropriate behaviour; harassment or discrimination.
Conduct
Falmouth Hockey Club regards discrimination and harassment as outlined above as gross misconduct and any member of
Falmouth Hockey Club who so discriminates against any other person shall be liable to appropriate disciplinary action.

As a member of Falmouth Hockey Club, I have read the above definitions and will conduct myself within the spirit and ethos of the club. *

Yes

Code of behaviour - spectators and parents

I agree with the above code of behaviour for parents and spectators. *

Yes

SECTION 7: ETHNICITY & DISABILITY

Whilst it is not compulsory for the following sections to be completed, the paragraph below explains why this personal information is considered to be important.Sport can and does play a major role in promoting the inclusion of all groups in society. However, inequalities have existed within sport particularly in relation to gender, race and disability. Sport England and England Hockey are committed to promoting and developing sports equity, which is about fairness in sport, equality of access, recognising inequalities and taking steps to address them. By monitoring the profile of people in sports clubs, national governing bodies of sport and Sport England can identify any issues relating to under representation of different groups and can develop strategies to ensure that all people have the opportunity in the future to develop and progress in sport.England Hockey requests this data from clubs as part of the annual affiliation process and completing this data accurately enables the club to give an accurate picture to England Hockey on our membership.

PLEASE TICK THE BOX THAT BEST DESCRIBES YOUR ETHNICITY *

White British

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

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

PLEASE TICK TO INDICATE ANY LEARNING OR PHYSICAL DISABILITIES

Deaf

Visually impaired

Hearing impaired

Physical disability

Learning disability

Multiple disability

N/A

Other:

Clear selection

Thank you for completing this form. Please ensure we are made aware of any relevant changes.

To ensure that we have the correct contact details for you, please complete the information requested above and return the form. This information will be used to keep you informed about Club events and to contact you in the event of an accident or incident. Some of the information is required to comply with the England Hockey Equity Policy, which has been adopted by the Club.

FALMOUTH HOCKEY CLUB COMMITTEE

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