OTHSC Player Registration Form Seniors 2013

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THE BUSHRANGERS One Tree Hill Soccer Club PO Box 275, One Tree Hill SA 5114 CONFIDENTIAL REGISTRATION FORM Season: 2013 ** (Please Print and complete ALL Details)** PARENT/GUARDIANS/PLAYERS named below are Members of the Club and are entitled and encouraged to participate in the Committee and management of the Club. Player Information Surname___________________ __________________ Given Names Date Of Birth_____/____/_______ Gender: Male / Female Preferred Name: Contact Address_________________________________________________________________________________ P/Code_____________ Phone________________________ Mobile______________________________ Email ___________  _____________________________ Medical conditions  _________________________________  _________________________ Glasses worn while playing? YES / NO (please refer to SAASL policy/OTH Info booklet for more information) Guardian/Emergency Contact Surname_____________________________________________ _________ First Name  ________________________________________ Phone________________________ Mobile______________________________ Relationship to player  _____________________________ Are you interested in becoming a Coach, Team Manager or Club Committee Member? ( PLEASE CIRCLE IF INTERESTED)  Alternative Emergency Contact Name__ Phone_ ___ Relati onship to player_________________ New Player Information only How did you find out about our Club? / Who referred you to our Club? Have you ever played for a SA Amateur Soccer League team?  YES / NO Club  Year_______ If Yes, Please provide a transfer form from your previous club and submit with your registration form If No, Please provide a Birth certificate/Drivers Licence and passport photo and submit with your registration forms. Registration cannot be accepted without the above information I give consent to the following: ( Please tick each box below) Being photographed and/or videoed at any SAASL sanctioned event. Such photos or videos taken can be utilized for any club purposes. Any medical information provided, and this registration form to be kept on file by this Club and SAASL.  The terms and conditions of reg istration, as well as the O.T.H.S.C. Cod e of Conduct, as set down by this club Receiving mail-outs / emails from this Club.  The above named player has my permission to play for One Tree Hill Soccer Club. Parent / Guar dian Declaration (if player under 18 years of a ge) I hereby certify that the above named player has my permission  to play soccer and that I will not hold the One Tree Hill Sports  Association Inc. or club memb ers and officials liable for any  hospital or medical expenses which may be incurred as a result  of injuries sustained whilst playing under the jurisdiction of the said association. I have read and agree to the OT.H.S.C. Terms & Conditions. Page 1 of 4 _____________ Initial Club Use Only SENIORS – SAASL

Transcript of OTHSC Player Registration Form Seniors 2013

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THE BUSHRANGERS 

One Tree Hill Soccer ClubPO Box 275, One Tree Hill SA 5114

CONFIDENTIAL REGISTRATION FORM

Season: 2013** (Please Print and complete ALL Details)**PARENT/GUARDIANS/PLAYERS named below are Members of the Club and are entitled and encouragedto participate in the Committee and management of the Club.

Player InformationSurname_____________________________________ Given Names_____________________________________

Date Of Birth_____/____/_______ Gender: Male / Female Preferred Name:

Contact Address_________________________________________________________________________________ P/Code_____________ 

Phone________________________ Mobile______________________________ Email ___________  _____________________________ 

Medical conditions  _________________________________ 

 _________________________ Glasses worn while playing? YES / NO (please refer to SAASL policy/OTH Info booklet for more information)

Guardian/Emergency Contact

Surname______________________________________________________ First Name ________________________________________ 

Phone________________________ Mobile______________________________ Relationship to player _____________________________ 

Are you interested in becoming a Coach, Team Manager or Club Committee Member? (PLEASE CIRCLEIF INTERESTED)

 Alternative Emergency Contact 

Name_________________________________________ Phone________________________ Relationship toplayer_________________ 

New Player Information only 

How did you find out about our Club? / Who referred you to our Club?

Have you ever played for a SA Amateur Soccer League team?  YES / NO Club Year_______ _

If Yes, Please provide a transfer form from your previous club and submit with your registration formIf No, Please provide a Birth certificate/Drivers Licence and passport photo and submit with your registrationforms.

Registration cannot be accepted without the above information

I give consent to the following: (Please tick each box below) Being photographed and/or videoed at any SAASL sanctioned event. Such photos or videos

taken can be utilized for any club purposes. Any medical information provided, and this registration form to be kept on file by this Club and

SAASL.  The terms and conditions of registration, as well as the O.T.H.S.C. Code of Conduct, as set down

by this club Receiving mail-outs / emails from this Club.  The above named player has my permission to play for One Tree Hill Soccer Club.

Parent / Guardian Declaration (if player under 18 years of age)

I hereby certify that the above named player has my permission to play soccer and that I will not holdthe One Tree Hill Sports  Association Inc. or club members and officials liable for any  hospital or medicalexpenses which may be incurred as a result  of injuries sustained whilst playing under the jurisdiction of the said association. I have read and agree to the OT.H.S.C. Terms & Conditions.

Page 1 of 4 _____________ Initial

Club Use Only 

SENIORS – SAASL

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THE BUSHRANGERS 

One Tree Hill Soccer ClubPO Box 275, One Tree Hill SA 5114

Date __/___/___  Parent / Guardian / Player Signature 

Parent / Guardian Name (Print)

Payment Details  Club use only 

Amount Paid___________________ Cash / Cheque / Money Order / E.F.T. Receipt #.____________ 

Date_____________  Forms Included : transfer form _________ Birth Certificate/D/Lic.#_____________ SAASL reg form ______ Photo ID ____ 

Registration received by ________________________________ Signed ______________________________ 

TERMS & CONDITIONS Season 2013 Please keep thisinformation for your record

 These terms and conditions may be changed at any time without notice.To qualify for early existing player registration

1) You shall be a current financial registered player of One Tree Hill Soccer Club.

2)  You shall make minimum payment of $50.00 and submit to One Tree Hill Soccer Club acompleted Registration Form no later than close of day on the 30th September 2012.

3) Pre-season registration confirms team placement for the following season provided a team isavailable.

Registrations

1) Registrations accepted with a minimum deposit of $40.00 and a completed, signedRegistration Form. Balance of fees are due NO LATER 15th February 2013.

2) Anyone not pre-registering shall register when General Registrations are offered, on a dateset by One Tree Hill Soccer Club.

3) Registrations for team placement shall be by order of registrations taken on that daywhether it be new or existing players.

4) No further registrations shall be accepted should an age group be fully subscribed.5) Players may be added to a waiting list in order of inquiry to be eligible for registration should

a position become available.6) New players shall supply a copy of proof of age (Birth certificate, Passport, Drivers Licence

etc.), a passport sized ID photo) and a completed SA Amateur League Player RegistrationForm.

7) Players transferring from another club shall supply a completed Transfer Form signed by thatClub Registrar or Club Secretary.

Payments

Payments shall be accepted by Cash, Cheque, Money Order or Electronic Funds Transfer (detailsbelow).All monies are to be paid NO LATER than 15th February 2013. Should you fail to make full payment by the due date, and are thus un-financial with the One TreeHill Soccer Club, you will not be eligible to play until all monies have been paid. Cheques and Money Orders to be made out to “One Tree Hill Soccer Club.” EFT details – ACC Name: One Tree Hill Soccer Club 

Bank SA BSB No. 105-056 ACC No. 103484540

Please ensure you retain your receipt/s for the duration of the season (for EFT, receiptswill be mailed)

Refunds1) No refund shall be given for transferring to any other club.

2) All refund requests are to be in writing and addressed to the Chairman prior to round 1.3) Refund requests after round 1 may only be approved at the discretion of the One Tree Hill

Soccer Club committee.

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THE BUSHRANGERS 

One Tree Hill Soccer ClubPO Box 275, One Tree Hill SA 5114

4) Prior to round 1 if a player no longer wishes to play for One Tree Hill Soccer Club and is nottransferring to another club, a refund of 50% may apply and is at discretion of the OTHSCcommittee).

5) A full refund shall only be available if One Tree Hill Soccer Club has not allocated a player aposition in a team.

6) Refunds will be issued after round 4.

Liability1) You are about to participate in a sport, which involves some risk to their safety. If you do it,you will give up your normal legal right to get compensation if you or your child/children arehurt. You can only get compensation if we break our safety code. You can see this code if youwant to. If you are worried, you should ask to see the code before going any further. It willtell you about the safety rules.

2) You shall not hold SA Amateur League Inc. or member clubs, officials and coaches liable toany legal, ambulance, hospital, dental or medical expenses, which may be incurred as aresult of injuries sustained whilst playing under the jurisdiction of the said Association.

3) In the event of an accident or emergency that requires you to receive medical or dentaltreatment (including ambulance transportation) and you cannot be contacted, you herebyconsent to the coach or One Tree Hill Soccer Club member deciding on the most appropriatemedical or dental treatment and you acknowledge that you shall be responsible for the

associated costs of such treatment.

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THE BUSHRANGERS 

One Tree Hill Soccer ClubPO Box 275, One Tree Hill SA 5114

Medical ConditionIt is your responsibility to ensure that you/your child is able to play and train; any medical conditionsshould be discussed with your coach and team manager.

Code of Conduct / Payment of Personal Fines1) You shall abide by the One Tree Hill Soccer Club and the SAASL Code of Conduct at all times

when associated with any SAASL sanctioned event.2) You agree to delegate your authority to the coaches and instructors involved. They may takewhatever disciplinary action they deem necessary to ensure the safety, well being andsuccessful conduct of the players as a group or individually.

3)  You take full responsibility for the payment of any and all *personal fines incurred.(ie. Cautions yellow/red cards)

• Player Send Off (Red card) $20.00*• Player accumulating 4 cautions

(Yellow cards) $20.00*• Player accumulating 8 cautions

(Yellow cards) $40.00*• Being the cause of a late start $25.00*

  Payment for any fines will be made within 7 days of notification.

* Fines are correct at time of printing but are subject to change without notice (SAASL )

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