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.
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 Meters)
Are all grounds boarded?
Yes
No
Width and Length of Arena(s) (in Meters)
The Arena walls are "x" meter high.
Programme:
Chukkas, Matches and Tournaments every week on both weekdays and weekends.
Chukkas Every Week, 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 an valid Riding Establishment License and HPA Coach.
Other
Membership Fees if applying for Club status (List one type and cost per box, e.g. Full - £700)
Number of Members in the past season . (Including chukka members)
Please name members wishing to join if your are a new club.
Do you have a club house at the site? If "Yes" please indicate opening times and facilities for members.
Club Positions - To be considered a polo 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 (Who should be separate from the polo manager)
HPA Coach
Chief Umpire
Handicap Committee (Minimum 3 Members)
Your nominated HPA Council represenative
First Name
Last Name
Conatct email for Council representative
example@example.com
Upload a copy of the full set of the clubs 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 clubs risk assessment
Browse Files
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.
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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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The club has Public Liability insurance with a limit of indemnity of no less than 5 million.
Yes
No
Other
Name of Insurer
Period of Insurance
The club will ensure for all polo matches a veterinary surgeon, who is a current member of the RCVS is either present or on immediate call and a club official is in attendance at all matches in case a welfare problem arises.
Yes
No
Other
The club will provide medical Cover For matches, as a minimum, two persons with First Aid qualifications are present and the local ambulance service is warned in advance that the match is taking place. For all other polo, at least one such person must be present.
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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