Junior Membership

First Name

Last Name

Sex
malefemale
Date of Birth

Street Address

City

Province

Postal Code

Country

Player Telephone

Player Email

If under the age of 18 please complete the following:
Parent's Name

Parent's Email

Parent's Telephone

Parent's Consent
I consent to my son/daughter playing field hockey with FHNS
Membership Options
---JuniorSeniorCoachUmpireAssociate
If applicable, please select all your roles in FHNS
PlayerCoachUmpireTeam CaptainBoard Member
Code of Conduct
I have read and understand the guidelines, rules and regulations issued for Field Hockey Nova Scotia (FHNS) events and I agree to be bound by them and that I will conduct myself in a manner that is respectful of myself and others at all times. I further agree that if I have not read the guidelines, rules and regulations of a FHNS event, my participation in the event is acceptance by me of the guidelines, rules and regulations which allow FHNS to disciipline if deemed behaviour is deemed unacceptable.

In consideration of FHNS’ acceptance of my entry to FHNS Events or my being permitted to take part in the Events and/or any activity associated therewith, I agree to: release, save harmless; and indemnify FHNS and/or its Agents from and against all claims, actions, costs and expenses and demands in respect to death, injury, loss or damage to my person or property, wheresoever and howsoever caused, arising out of, or in connection with, my taking part in the Event and notwithstanding that the same may have been contributed to or occasioned by any act or failure to act (including, without limitation, negligence) of the FHNS and/or any one or more of its Agents.

I further agree and acknowledge that:
-The rules governing the Events are solely for the purpose of regulating the Events and it remains my sole responsibility to act and govern myself in such a manner as to be responsible for my own safety;
- I am aware of the risks inherent in participating in the Events;
- I assume the risks and waive notice of all conditions dangers or otherwise, in or about the Events;
- I am aware that failure to wear a mouth guard while playing field hockey voids my Field Hockey Canada insurance coverage for dental injuries;
- The above personal information will only be made available for use by Field Hockey Nova Scotia (FHNS) and Field Hockey Canada (FHC) for the purposes of providing me with services and for statistical purposes;
- FHNS and FHC will not share, give, rent or sell my individual personal information with anyone without my advance permission or unless ordered by a court of law; and
- FHNS and FHC may provide aggregated non-personal information with third parties for the purposes of securing sponsorships or other services.
I agree that I have read and understand the code of conduct