2012 SMOG NETBALL membership Registration

All players who wish to trial for SMOG in the 2012 season, must register via the on-line registration form.  Please get your registration done at least 3 days prior to the first day of the trials that you will be attending.  This will ensure we have all your information, resulting in a smoother trials process for everyone. 

You will receive a message on screen when your registration has been successfully completed and received.  If you have any trouble with the on-line registration process, please email smogwebadmin@gmail.com

PLEASE NOTE:  

  • By registering, you are committing to pay a $10 trialling fee, which must be paid via internet banking before trials. This fee will be deducted from your subs, but will not be refunded if you decide not to play for SMOG.  See the NEWS page for SMOG's bank account details.
  • You are expected to attend all trial days (in your chosen grade), unless you have made an arrangement with the Trials Co-ordinator prior to trials beginning.     

       

When filling out the on-line registration, please:

  • Do not type anything in the 'MARRIED NAME' Field unless you are married (i.e. ignore the red instruction)
  • Do not put any spaces or hyphens in any of the 'PHONE NUMBER' Fields (e.g. 02741234567)

MEMBERSHIP REGISTRATION

To register please read and complete the following sections: PERSONAL DETAILS, OTHER DETAILS, READ THE DECLARATION then REGISTER.

PERSONAL DETAILS

MEMBER DETAILS

Please fill in your details below.

FIRST NAME *

LAST NAME (@ BIRTH) *

PREFERRED NAME

GENDER

OTHER ETHNICITY

STREET ADDRESS

HOME PHONE *

WORK PHONE

MIDDLE NAME

MARRIED NAME *

DOB *

ETHNICITY

OCCUPATION

SUBURB

MOBILE *

eMAIL

* MANDATORY INFORMATION

Ensure the list of mandatory information has been filled in, this information is required to enable you to register

First Name, Last Name or Married Name, Date of Birth, Home Phone Number or Mobile Phone number

OTHER DETAILS

TRIALING DETAILS

Players must attend all trial dates (for their grade) if possible. In special cases, we may be able to make exceptions or offer another trialling option. In these circumstances, please contact the Trial Co-ordinators via email at smognetball@gmail.com, BEFORE the trials you are attending.

Select the Grade/s you wish to Trial for:
SMOG 1-2 (PREMIER 1) / SMOG 3-5 (PREMIER 2/3) / SMOG 6-8 (PREM RES/SENIOR 1A) / SMOG 9-10 (SENIOR 1) / SMOG 11-12 (SENIOR 2 - SOCIAL)

Select the preferred position/s you wish to Trial for:
1st Choice / 2nd Choice / 3rd Choice

PREVIOUS PLAYING HISTORY

Please supply your previous playing history by naming the last club you were registered with, grade and position/s you played in the box below.


ADMINISTRATION DETAILS

If you are interested in helping out in any role - big or small - please indicate details below.

I am available for:
Coaching / Co-Coaching / General Admin or One-off Help / Team Manager

UNIFORM DETAILS

For those that do not own a playing uniform, we will be hiring out uniforms this season (with a bond). If you require one, please indicate below.

Please indicate uniform sizes you require:
Skirt Size / Top Size

DECLARATION

Netball WELLINGTON REGION declaration

  1. The details I have provided are true and correct. If they change I will notify the Netball Centre, the Regional Entity or Netball New Zealand (NNZ), in writing, as soon as possible.
  2. I understand that in registering as a member of the Netball Centre, I become a member of the Regional Entity and NNZ. I agree to be bound by the constitutions, regulations, policies, manuals, guidelines and reasonable directions of those organisations.
  3. I understand that there are inherent risks of danger and injury in netball. I agree that Netball Centre, Regional Entity and NNZ are absolved from all liability arising from injury or damage arising out of my participation in any activity.
  4. I release, discharge and indemnify the Netball Centre, Regional Entity and NNZ from all proceedings, claims, demands, losses, damages, penalties, costs and expenses arising from or in connection with my participation in netball.
  5. If I play or umpire netball, I believe I am medically and physically fit and able to participate. If I am injured or ill, it is my responsibility to inform my coach and my team and take such steps as a medical practitioner recommends.
  6. I agree that the personal details on this form will be collected by my club or school, the Netball Centre, the Regional Entity and NNZ in accordance with the Privacy Act 1993 for the purposes of:
    1. processing this application and administration of the database including disclosure of information on the database between the organisations;
    2. enabling the organisations to carry out their various functions under their respective constitutions, regulations and policies;
    3. complying with the law;
    4. communicating with me and providing information relating to my role in netball; and
    5. enabling authorised sponsors to provide me with promotional and marketing material, unless otherwise indicated.
  7. I am entitled to have access to and correct my personal information.
  8. I agree to being photographed, filmed, videoed or have my image recorded, and that the Netball Centre, Regional Entity and/or NNZ may use such imagery in connection with the promotion of netball. I am entitled to request access to such images and to take copies of them at my cost.

REGISTRATION

To REGISTER your details, you must agree to the declaration as specified above.

I will accept promotional/marketing material (optional).
I have read and accept the declaration defined above (Mandatory) .
click the REGISTER button to register your details