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Print out this form, complete it and post it to the organiser below.

 

YOUNG PLAYERS’ COURSE (BOYS & GIRLS)    No:  ________

ABERYSTWYTH - MONDAY  JULY 21st – FRIDAY JULY 25th 2003

 

APPLICATION FORM - PLEASE USE BLOCK LETTERS

 

Full Name:      _________________________________________    Date of Birth: _________________

 

Address:        _______________________________________________________________

 

                     _______________________________________________________________

 

Post Code:    _________________Tel: (inc. code)   _________________________________

 

Email:            _______________________________________________________________

 

School:          _______________________    Club:   ________________________________

 

Playing Experience:   _________________________________________________________

 

Position: 1st choice:   ___________________   2nd choice:   __________________________

 

I enclose (please complete  as appropriate): Cheque / P.O. No:  __________________________

 

for £50 non-returnable deposit.   Cheques should be made payable to:

  

 "WELSH HOCKEY UNION - ABERYSTWYTH"

I understand that:

The deposit is not returnable once a place is reserved

Repayment of balance on withdrawal is at the discretion of the WHU Finance Committee.

The WHU, SPORTS COUNCIL FOR WALES, its servants, agents and employees are not under any liability whatsoever in respect of personal injury, loss or damage, however caused whilst attending the course.

 

Signed:   __________________________   Parent / Guardian   Date:   _________________

 

Application forms should be returned immediately to the Course Organiser:

 

Ms M Smith, "Rhosfadog", Trefriw, Conwy, LL27 0RJ

 

*Please remember to include a stamped, addressed envelope (9” x 4”)*

  

Application Form produced from the Welsh Hockey Web Site  www.welsh-hockey.co.uk