Club Affiliation Application Form
I would like to apply for:
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NEW Provisional Club Affiliation UK
FULL Club Affiliation upgrade UK
Overseas Club Affiliation
Other
My application is for an:
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Arena Club
Outdoor Club
Both Arena and Outdoor
Club Name
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Club Phone Number
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Please enter a valid phone number.
Format: 00000 000 000.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dedicated Club E-mail Address
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example@example.com
Width and Length of Ground(s) (in Metres)
Are all grounds boarded?
Yes
No
Width and Length of Arena(s) (in Metres)
How high are the arena walls? (in metres)
Programme:
Chukkas, matches, and tournaments every week, on both weekdays and weekends.
Chukkas every week, with matches and tournaments 2-3 weekends a month.
Chukkas most weeks. A handful of matches and tournaments in a season.
Other
Do you offer lessons and pony hire?
No
Yes, and we have a valid Riding Establishment Licence and HPA-licensed Coach
Other
REL Number (if applicable)
Name of Coach (if applicable)
Membership Fees (if applying for UK Club status). List one type and cost per box, e.g. Full Membership - £700.
Overseas Clubs Only: Number of members in the past season (including chukka members)
Anticipated number of members (for new clubs):
Do you have a club house at the site? If "Yes" please indicate opening times and facilities for members.
Club Positions - To become an affiliated club, the following positions must be allocated as this distinguishes a club from a private facility.
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Rows
Full Name(s)
Chairman
Polo Manager
Secretary
Treasurer
Welfare Officer (Must different from the Polo Manager)
HPA Coach
Chief Umpire
Handicap Committee (Minimum 3 Members)
Safeguarding Officer
Your nominated HPA Council Representative
First Name
Last Name
Conatct email for Council Representative
example@example.com
Upload a copy of the full set of the Club's rules, including the Club Constitution.
Browse Files
Drag and drop files here
Choose a file
A sample set of rules can be found on the HPA "Become a club page"
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Upload a copy of the Club's Risk Assessment
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Drag and drop files here
Choose a file
A sample Risk Assement template can be found on HPA "CLUBS" page.
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Planned fixture list for the season.
Browse Files
Drag and drop files here
Choose a file
Please upload the fixtures that members will be able to particpate in at your club
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Does the Club have Public Liability insurance with an indemnity limit of at least £5 million?
Yes
No
Other
Name of Insurer
Period of Insurance
The club will ensure that an RCVS-licensed veterinary surgeon will be either present or on immediate call in accordance with current HPA Rules.
Yes
No
Other
The club will ensure that the Welfare Officer (or their representative) is in attendance in accordance with current HPA Rules.
Yes
No
Other
The club will provide medical cover as specified in the current HPA Rules.
Yes
No
I have read and understood the current year book and I understand and agree to be bound by the Articles, Regulations and Rules of the HPA and confirm that the club is able to meet the administrative requirements of the HPA.
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Name of Signatory
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First Name
Last Name
Submit
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