MHA Player Registration | Mpumalanga Hockey

Mpumalanga Hockey Association

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Team Registration for

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INSTRUCTIONS

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I understand I may need to pay for trials

I have all the information and document(s) I need, I'm ready to proceed

THIS SECTION IS TO BE COMPLETED BY THE REGISTRANT (THE PERSON ATTENDING TRIALS)

I confirm that I am the Registrant and I am above 18

POPI ACT CONSENT

This registration process will ask for some of your personal information. Before proceeding, we are required by the Protection of Personal Information Act to receive your consent to collect that information. Please note that if you are not older than eighteen, this consent MUST be given by your parent or guardian. A more detailed explanation, including what information we collect, your rights, and what we do with the information can be found at the following link:

POPIA CONSENT POLICY

I consent to my personal information being collected and used as outlined in the above policy.

INDEMNITY DISCLAIMER

I, the undersigned participant, acknowledge that my participation in the Mpumalanga Hockey Association trials is voluntary and entirely at my own risk. I understand these risks and agree that it is up to myself, under advice from a heath care professional, to determine if I am healthy enough to take part in these trials.

I hereby indemnify and hold harmless the Mpumalanga Hockey Association and the trials' venue, their staff, officials, organisers, coaches, and any associated parties from any claims, damages, or liabilities arising from injury, loss, or harm incurred during the trials, except in cases of gross negligence or wilful misconduct.

Signed By (Name)

ID Number

To Continue, please confirm you are the registrant and are older than 18

SECTION 1 PLAYER DETAILS

Please add your details below.

Fields marked with * are required fields.

First Name (as in ID)

Last Name (as in ID)

Known Name (If differerent to first name)

Contact Number

Contact Email

Date of Birth

ID Number

I am a South African Citizen

I am Not a Member of a Club

Club Message

City or Town of Residence

SAHA Registration Number

SECTION 2 MEDICAL INFORMATION

Emergency Contact Name

Emergency Contact Number

Family Doctor

Doctor's Contact Number

I do not Have Medical Aid Cover

Medical Aid Name *

Medical Number *

Main Member Name and ID Number *

Dependant Code

Any Allergies we should know about?

Any Medication we need to know about

Any Special Dietary Requirements?

Any other information we should be aware of?

SECTION 3 PREVIOUS EXPERIENCE

I have played for Team Mpumalanga before

Please provide more information. Team, year, etc.

Please provide any additional information you think might be relevant. Such as experience with other teams.

SECTION 4 Supporting Documents

Please upload the following documents. These are optional, unless indicated below. Document files should be a PDF or MS Word DOC file. Image files should be a JPG, a PNG, or a sililar file type.

Hockey CV

Upload Doc

Max: 2 MB

Player Photo

Upload Image

Max: 2 MB

ID Document

Upload Image

Max: 2 MB

TOURNAMENT INFORMATION

Mpumalanga Highveld CDs Ladies

No Upcoming Tournaments

I acknowlege the selection criteria and shall accept the decisions of selection committee as final.

I acknowlege that there may be a charge to attend Trials

I acknowledge that, should I be selected for the team, I will be responsible for ensuring that my tournament costs will be paid. These may include costs such as tournament fees, transport fees, accommodation costs, kit costs, etc.

Submit Registration

Once you have ensured that all the required details have been correctly entered, click the Submit button to send us your registration.

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Please check you have entered all the required information and try again.

Your registration has been submitted successfully.

THANK YOU

THIS SECTION IS TO BE COMPLETED BY THE PARENT/GUARDIAN OF REGISTRANT (THE PERSON ATTENDING TRIALS)

I confirm that I am the parent or guardian of the Registrant

POPI ACT CONSENT

This registration process will ask for some personal information, both yours and that of the player you are registering. Before proceeding, we are required by the Protection of Personal Information Act to receive your consent to collect your information, as well as ensure that you consent on behalf of your child/ward, to the collection and usage of their information. A more detailed explanation, including what information we collect, what your rights are, and what we do with the information, can be found at the following link:

POPIA CONSENT POLICY

I consent to my personal information being collected and used as outlined in the above policy.

I consent to my child/ward's personal information being collected and used as outlined in the above policy.

INDEMNITY DISCLAIMER

I, the parent/guardian of the registrant, acknowledge that participation in the Mpumalanga Hockey Association team trials is voluntary and entirely at our own risk. I understand these risks and agree that it is up to myself, under advice from a healthcare professional, to determine if my child/ward is healthy enough to take part in these trials.

Signed By (Name)

ID Number

To Continue, please confirm you are the parent/guardian of the registrant