Registration:
Name: First: Last:
Gender and Team:
  note: If you are a new member, please select the team you would like to play for.
Email:
  Email will be our preffered method of contact, but if you do not have an email address then please ensure we have your mobile number instead.
BHC member?
  If you have answered yes to the above, what is your current BHC shirt number?

Telephone: Home: Mobile:
Address:
Occupation: This information will only be used to form a network of club contacts

Club News: Yes, please, sign me up for the club newsletters! (check this box to receive news from BHC)
Umpiring: Please tick this box if you would be happy to help out and Umpire for other club teams?
Coaching: Do you have any coaching qualifications, if so please provide details
  Please tick this box if you would you be interrested in helping to coach at BHC?
  Basingstoke Hockey would like to contact you occasionally. Please click this checkbox if you do not want us to use the details provided on this page.
IMPORTANT: Under the dataprotection act, Basingstoke Hockey Club will NEVER pass on your details to anyone outside of the club without your written consent.