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THE BUSHRANGERS

One Tree Hill Soccer Club PO Box 275, One Tree Hill SA 5114

Age Group/Team

Club Use Only

CONFIDENTIAL REGISTRATION FORM Details) Season: 2013

(Please Print and complete ALL

** PARENT/GUARDIANS named below are Members of the Club and are entitled and encouraged to participate in the Committee and management of the Club.**

Player Information
SURNAME___________________________________Given Names_______________________________Boy / Girl
Date Of Birth_____/____/_______Age at the 1st January 2013________Intended age group for 2013___________________ Age Group played in 2012____________Team Name________________________Coach________________________________ Child Medical conditions / Learning difficulties:

Glasses worn while playing? YES / NO information)

(please refer to EDJSA policy/OTH Info booklet for more

New Player Information only
Have you ever played for an Elizabeth & Districts Junior Soccer Assoc. Club ? YES / NO Club Year_______ _ If Yes, Please provide a green transfer form from your previous club and submit with your registration form If No, Please provide a Birth certificate and passport photo (photo only req. if playing U9 thru to Colts) and submit with your registration form (passport photo NO smaller than 3.5x4.5 cm -> from your school photo package will suffice).

Registration cannot be accepted without the above information
Mother / Guardian Surname______________________________________ First Name_______________________________ Contact Address_____________________________________________________________________P/Code______________ Phone________________________Mobile__________________________Email___________ ________________________ Father / Guardian Surname_______________________________________ First Name_______________________________ Contact Address_____________________________________________________________________P/Code______________ Phone________________________Mobile__________________________Email______ _____________________________ Do you have any coaching or official qualification? YES / NO If yes, at what level? ______________

Are you interested in becoming a Coach, Team Manager or Club Committee Member? (PLEASE
CIRCLE IF INTERESTED)

Alternative Emergency Contact
Name_________________________________Ph:_______________________Relationship to Child______________________ I give consent to the following: (Please tick each box below)  My child being photographed and/or videoed at any E.D.J.S.A. sanctioned event. Such photos or videos taken can be utilized for official OTHSC and EDJSA purposes.  Any medical information provided, and this registration form to be kept on file by this Club and E.D.J.S.A. Page 1 of 4 ______________ Initial

THE BUSHRANGERS
One Tree Hill Soccer Club PO Box 275, One Tree Hill SA 5114
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The terms and conditions of registration, as well as the O.T.H.S.C. Code of Conduct, as set down by this club My Child receiving mail-outs from this Club. The above named player has my permission to play for One Tree Hill Soccer Club

Parent / Guardian Declaration
I hereby certify that the above named player has my permission to play soccer and that I will not hold the One Tree Hill Soccer Club Inc. or club members and officials liable for any hospital or medical expenses which may be incurred as a result of injuries sustained whilst playing under the jurisdiction of the said association. I have read the attached terms and conditions.

Date

__/___/___

Parent / Guardian Signature Parent / Guardian Name (Print)

Payment Details
.

Club use only
Receipt E&D reg form _____

Amount Paid_____________ Cash / Cheque / Money Order / E.F.T. No.________________Date____________ Forms Included : Photo ID ______ EDJSA transfer form _____

Birth Certificate/CAFHS ______

Registration received by _______________________________

Signed ______________________________

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THE BUSHRANGERS
One Tree Hill Soccer Club PO Box 275, One Tree Hill SA 5114

TERMS & CONDITIONS

Season 2013

Please keep

this information for your record

These terms and conditions may be changed at any time without notice. To qualify for early existing player registration (‘Priority Registration’) – maintaining 2012 registration pricing 1) You shall be a current financial registered player of One Tree Hill Soccer Club. 2) You shall make full payment of fees and submit to One Tree Hill Soccer Club a completed Registration Form no later than close of Junior Presentation on the 16th September 2012. 3) Pre-season registration confirms team placement for the following season provided a team is available. Registrations 1) Registrations accepted with a minimum deposit of 50% of fees and a completed, signed Registration Form. Balance of fee is due PRIOR TO ROUND 1 GAME. 2) Anyone not pre-registering shall register when General Registrations are offered, on a date set by One Tree Hill Soccer Club. 3) Registrations for team placement shall be by order of registrations taken whether it is new or existing players. 4) No further registrations shall be accepted should an age group be fully subscribed. 5) Players may be added to a waiting list in order of inquiry to be eligible for registration should a position become available. 6) New players shall supply a copy of proof of age (Birth certificate, Passport etc.), a passport sized ID photo (U9 to Colts only) and a completed blue EDJSA Player Registration Form. (Passport photo from your school photo packages will suffice but MUST BE NO SMALLER THAN 3X4cm). 7) Players transferring from another club shall supply a completed green Transfer Form signed by that Club Registrar or Club Secretary. Payments Payments shall be accepted by Cash, Cheque, Money Order or Electronic Funds Transfer (details below). All monies are to be paid PRIOR TO THE 1st ROUND.  Cheques and Money Orders to be made out to “One Tree Hill Soccer Club.”  EFT details – ACC Name: One Tree Hill Soccer Club Bank SA BSB No. 105-056 ACC No. 103484540  Please ensure you retain your receipt/s for the duration of the season (for EFT, receipts will be mailed) Refunds 1) No refund shall be given for transferring to any other club. 2) All refund requests are to be in writing and addressed to the Chairman prior to Round 1. 3) Refund requests after round 1 may only be approved at the discretion of the One Tree Hill Soccer Club committee. 4) Prior to round 1 if a player no longer wishes to play for One Tree Hill Soccer Club and is not transferring to another club, a refund of 50% may apply. 5) A full refund shall only be available if One Tree Hill Soccer Club has not allocated a player a position in a team. 6) Refunds will be issued after round 4. Community Involvement 1) Each family is expected to and agrees to participate in one home game per season within the canteen. Club Uniform 1) Each player is expected to wear the current club uniform, including current socks and shorts. Liability 1) Your child/children are about to participate in a sport, which involves some risk to their safety. If your child/children do it, you will give up your normal legal right to get compensation if you or your child/children are hurt. 2) You shall not hold the Elizabeth & Districts Junior Soccer Association Inc. or member clubs, officials and coaches liable to any legal, ambulance, hospital, dental or medical expenses, which may be incurred as a result of injuries sustained whilst playing under the jurisdiction of the said Association. 3) In the event of an accident or emergency that requires your child to receive medical or dental treatment (including ambulance transportation) and you cannot be contacted, you hereby consent to the coach or One Tree Hill Soccer Club member deciding on the most appropriate medical or dental treatment and you acknowledge that you shall be responsible for the associated costs of such treatment.

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THE BUSHRANGERS
One Tree Hill Soccer Club PO Box 275, One Tree Hill SA 5114 Medical Condition It is your responsibility to ensure that your child is able to play and train; any medical conditions should be discussed with your coach and team manager. Code of Conduct 1) You shall abide by the One Tree Hill Soccer Club and the Elizabeth & District Junior Soccer Association’s Code of Conduct at all times when associated with any Elizabeth & Districts Junior Soccer Association sanctioned event. 2) You agree to delegate your authority to the coaches and instructors involved. They may take whatever disciplinary action they deem necessary to ensure the safety, well being and successful conduct of the players as a group or individually.

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