Youth club affiliation form

Youth Club Name *

District *

Is your club part of a senior hockey club? *

If Yes, which club?

Contact Name *

Invoice Address *

Postcode *

Telephone Number *

Email Address *

Please give the names and qualifications of coaches who deliver hockey in your club

Please give the names of feeder schools who play hockey and link to your club

How do you wish to pay? (please note that youth clubs who are part of senior club will have affiliation fee covered)
ChequeInvoice