SUHA Registration SUHA registration First Name:* Surname:* Email* Invoice and club emails will be sent to this address.Phone (Home) Phone (Business) Phone (Mobile) Date of Birth* DD slash MM slash YYYY Gender M F 2016 Playing club* 2016 Winter Team for your club* Why do you want to be part of the Southern United Hockey AcademyAre you a field player or goalie?* Field Player Goalie I am a part of the Hockey Victoria Academy Yes No Address (No./Street)* Address (Suburb)* Address (Postcode)* Parent 1 Parent 1 Email Club emails will also be sent to this address, invoice will NOT be sent to this address.Parent 1 Phone #Parent 2 Name Parent 2 Email Club emails will also be sent to this address, invoice will NOT be sent to this address.Parent 2 Phone #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. Playing with Southern United Hockey Club* If accepted into the Southern United Hockey Academy I will play for Southern United Hockey Club in 2017 Payment* If accepted to Southern United Hockey Academy I will pay the $240 ($100 if HV Academy)
