Registration 2016 Registration Form 2016 New SUHC Members I am a new member Today's Date* Day Month Year First Name:* Surname:* Gender* M F Date of Birth* DD slash MM slash YYYY Email* Invoice and club emails will be sent to this address.Alternate Email Address 1 Club emails will also be sent to this address, invoice will NOT be sent to this address.Alternate Email Address 2 Club emails will also be sent to this address, invoice will NOT be sent to this address.Phone (Home) Phone (Mobile) Address (No./Street)* Address (Suburb)* Address (Postcode)* Pricing All playing members MUST register with Hockey Victoria and pay the additional - $65 - for those over 18 or - $50 - for those under 18 Category Mens Womens Masters Student playing Men's Student playing Women's Juniors U12 - U18 Juniors U10 Juniors U8 Gold Non-Playing Non-Playing Life Associate *** if playing juniors and seniors, please select Junior U12-U18 and then select the appropriate secondary category ***Men* Winter Playing Fees = $525.00 Winter Goalie Fee (owWinter Goalie Fee (own gear) = $185.00 Women* Winter Playing Fees = $525.00 Winter Goalie Fee (own gear) = $185.00 Masters* Winter Playing Fees = $525.00 Winter Goalie Fee (own gear) = $185.00 Juniors* Winter Playing Fees = $260.00 Winter Goalie Fee (own gear) = $185.00 Under 12, 14, 16 and 18U/10* Winter Playing Fees = $145.00 Intra Club Hockey* Intra Club Under 8 You must register with Hockey Victoria and pay the $50 registration for insurance purposes. Student playing Men's* Winter Playing Fees = $385.00 Winter Goalie Fee (own gear) = $185.00 Student playing Women's* Winter Playing Fees = $385.00 Winter Goalie Fee (own gear) = $185.00 Life* Life Member Playing Fee = $100.00 Non-Playing* Annual Membership = $30.00 Gold Non-Playing* Annual Membership = $100.00 Associate* Annual Membership = $30.00 Secondary Category Masters* N/A Masters playing Mens = $130.00 Masters playing Womens = $130.00 Secondary Category Seniors* N/A Senior playing Masters = $130.00 Secondary Category for Juniors* N/A Junior playing Mens = $130.00 Junior playing Womens = $130.00 Junior girl playing 2 junior age groups = $130.00 Umpiring Fee* Umpiring Fee = $30 The $30 umpiring surcharge will be refunded if player umpires a men's game as requested.Premier League & Reserves Levy PL/PLR Levy = $75.00 Premier League and Reserves Levy of $75.00 which will be applied to those players who play 6 or more games in either the PL or Reserves teams. This levy is to cover the increase to cost for those teams.Optional Fund Raising Levy - Juniors Fundraising Levy = $30.00 Feedback to the club has been that some players and parents would prefer to make a one off donation via a levy as they can’t participate in club fundraising events during the season. All money collected via this levy goes into our ground replacement fund or strategic initiatives. Optional Fund Raising Levy - Seniors Fundraising Levy = $50.00 Feedback to the club has been that some players and parents would prefer to make a one off donation via a levy as they can’t participate in club fundraising events during the season. All money collected via this levy goes into our ground replacement fund or strategic initiatives. Total $ 0.00 *Payment instructions will be emailed to you once the form has been submitted.Occupation School/College you attend* If Under 18If player is under 18, please fill in belowParent 1 Parent 1 Phone #Parent 1 Occupation Parent 2 Name Parent 2 Phone #Parent 2 Occupation Agreements.Terms* I hereby agree to be bound by the Rules, By-Laws and Regulations of the Southern United Hockey Club, Inc as amended by the Committee of Management from time to time. Click here for full details Photos* I consent to Southern United Hockey Club and its agents recording images of me at club events, training and games for promotional purposes. I consent to these images being used in promotional material including on the world wide web or any other media. HV registration* I will register with Hockey Victoria and pay the $50(u18) or $65(over 18) Umpiring:* I agree to umpire one or more games as required by the SUHC Hockey Club. Refer Umpiring Section on website for more details.
