February GK Course Booking Form

Please complete a separate form for each player due to different medical information and consent.

Junior Player LAST Name:*

Junior Player FIRST Name:*

Junior Player Birthdate - please use this format: dd-mm-yyyy:*

GHC Member - please indicate 2015/16 squad if GHC Member:

Wednesday 17 February (tick if attending):

Thursday 18 February (tick if attending):

Name of Parent (or Guardian) giving consent:*

Parent email address:*

Parent home phone:*

Parent mobile phone:*

Parent address and post code:*

Medical information our coaches should be aware of:*

I accept the GHC Policies (please type: yes):*
	To read our Policies, please see the Safeguarding Children button on the Juniors page of the GHC website

I consent to my child taking part in the hockey course (please type: yes):*

I consent to the GHC photography policy (yes or no):*
	Photographs and/or video may be taken during matches and training session by approved agents and officers of Guildford Hockey Club. Such images shall be used for publicity and training purposes in accordance with the Guildford Hockey Club Safeguarding and Protecting Young People Policy and Photography Policy. By choosing yes, you consent for your child to feature in such images which may be used by agents and officers of the Club for marketing purposes, eg local newspapers, magazine, promotional articles including flyers, brochures and the Club's website. We do not publish full names with photographs.

Other information you would like us to know:

Enter not this field:

*Indicates a field you must enter.

When you have completed the form, please click the 'Send details' button ONCE to send.