DFHC Indoor Women's Field Hockey Registration 2024-2025

Durham Field Hockey Club Registration

2024-2025 Indoor Women's League
Player's Name*

First NameLast Name
E-Mail Address*
Primary Phone Number:*

Area CodePhone Number
Secondary Phone Number:

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date:*

MonthDayYear
Emergency Contact Name:*

First NameLast Name Relationship to Player
Emergency Contact Phone #:*

Area CodePhone Number
Secondary Emergency Contact (optional):

First NameLast NameRelationship to Player
Secondary Emergency Contact Phone # (optional):

Area CodePhone Number
Do you have any health conditions or concerns that we should know about? (i.e. asthma, allergies, current/previous injuries, do you carry an EpiPen/inhaler, etc.)*
How did you hear about the Durham Field Hockey Club?

A friend or colleagueFacebook/Twitter/InstagramSign/PosterWebsiteOther
Have you played indoor field hockey previously?
Do you have your own indoor field hockey stick?
Please rate your field hockey experience level (check all that apply):

Beginner to Field HockeyRecreational ExperienceCompetitive ExperienceHigh School TeamUniversity TeamOther
Are you a goaltender?

YesNo
Please rank your position preference (drag and drop):
If you would like to request to be placed on a team with another player/players in the league, please list name(s) below: **NOTE: We will do our best to accommodate your request but CANNOT make any guarantees. Our first priority is to create even and well-balanced teams**
Do you own a DFHC reversible sleeveless black/white jersey?*

YesNo, I will need to purchase a jersey for $30

Registration Fees
Membership Type:*

Indoor Women's League Registration $175 (Nov 2024 to April 2025)
Total Fees Due:
Payment Method (please select one):*

E-transfer to durhamfieldhockeyclub@gmail.com (*No password required but if e-transfer name does not match the player name, please indicate in e-transfer notes/memo*)Cheque, made payable to Durham FHC (bring cheque with you on the first night)Cash (bring cash with you on the first night)
Player Code of Conduct
1) Players will refrain from using profanity during games and practices.

2) Players will not engage in disparaging dialogue regarding/toward umpires, teammates, coaches or opponents during games and practices.

3) Players will not, under any circumstance, participate in physical violence or threats thereof during games and practices.

4) Players will make every reasonable effort to familiarize themselves with and abide by the FIH Rules of Outdoor Field Hockey (available online at www.fih.ch) in an effort to preserve the integrity of our sport and the safety of all players.

5) Players will make every effort to be on time to games and prepared to take the field with full uniform and safety equipment at game time. Players who are unable to attend a game will notify their team captain a minimum of 24 hours prior to game time.

6) Courtesy and Respect—Durham FHC will not permit blaming, name calling, teasing, criticizing, or other acts intended to hurt feelings or cause injury to anyone.

7) Positivity and Teamwork—Players understand that Durham FHC is a recreational and inclusive club which encourages participation by players of varied skill levels. Players will endeavor to support their fellow teammates/participants in a positive manner on and off the field.
Player Declaration:
IFirst Name*   Last Name* agree to abide by all rules and regulations set out by Durham FHC. I understand that the collection of my personal information will be used only for DFHC communications, and I consent to the use of photos taken (of me) at field hockey for promotional uses. I understand that the consequences of breaking the above Code of Conduct may vary from reduced playing time to game suspension and possible dismissal from the league and that in the event of a suspension/dismissal, I will be held responsible for all associated costs including the possible forfeiture of all fees previously paid to Durham FHC.

Date

Signature
AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY

Please take your time to read and review.
In consideration of being allowed to participate in any way in the Durham FHC athletic/sports program, related events and activities, the undersigned acknowledges, appreciates and agrees that:

1. The risk of injury from participation is significant and includes, but is not limited to: the potential for exposure to weather and environmental elements, physical exhaustion, sprain and strain, permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. I ACKNOWLEDGE AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual and/or significant hazard during my presence or participations, I will remove myself from participation and bring such to the attention of the nearest official immediately; and

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Durham FHC, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property. WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASES OR OTHERWISE.
For players ages 18 and older at the time of registration:

(Please type your name & sign below)
I      Player/Participant's First & Last Name   HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Date

Signature
For players under age 18 at the time of registration:

(Please have your parent/legal guardian type their name & sign below)
I   Parent/Legal Guardian's Full Name am signing the above CODE OF CONDUCT and RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT on behalf of a child under 18 years of age and I confirm that I am the child’s parent or legal guardian, or that I otherwise have legal authority to sign this Agreement on behalf of the child. I consent and agree to his/her release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above.

Date

Signature
Once you submit your registration, please do not forget to forward your registration payment in whichever form you have indicated above. If paying by cash or cheque, please bring your payment to Kingsway College on the first night of the indoor season.

Thank you and we look forward to having you as part of the Durham Field Hockey Club for the 2024-25 Indoor Season!
Should be Empty:

	Shirt Size
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL

Durham Field Hockey Club Registration

Registration Fees

Player Code of Conduct

Player Declaration:

AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY

For players ages 18 and older at the time of registration:

For players under age 18 at the time of registration: