Memberships

Make sure you fill in the correct form for your age group. Juniors are under 18 and Adults are anyone over 18.

Junior Membership Form (U18)

Members Name
Address
e.g. 1234?
e.g. 10
Please detail below any important medical information that our coaches/Junior Coordinator should be aware of (e.g., epilepsy, asthma, diabetes etc.)
Emergency Contact Name 1
Please insert the information below to indicate the person(s) who should be contacted in event of an incident/accident.
Emergency Contact Details 2 (Parent/Guardian)
Please insert the information below to indicate the person(s) who should be contacted in event of an incident/accident.
Emergency Declaration
Emergency Contact Information Update
Travel / Transport
At times, your child may be required to travel to games, training or other events, either using public transport or private vehicles. Please read the permission options above and tick all that you feel comfortable with.
Breakaways Netball Kit Declaration
Photography / Film Declaration
Select 1 of the above options. Breakaways netball is committed to the protection of children and vulnerable adults involved in sport. In accordance with our Child and Vulnerable Adults Protection Policy and Procedures, where possible we will not permit photographs, film, video or other images of children or vulnerable adults to be taken or used without the consent of the child/vulnerable adult and their parents/guardians or carers. Breakaways Netball will take all reasonable measures to ensure any images are used solely for the purposes for which they are intended. If you become aware these images are being used inappropriately you should inform the Club Child Protection Officer immediately.
You can view the Policies here.

Adult Membership Form (18 & Over)

Your Name
Address
e.g 1234?
Affiliation Type (Please select all that apply)
Do you consider yourself to be disabled under the Equality Act 2010? The Equality Act 2010 defines a person as disabled as an individual that has a physical or mental impairment that has a substantial and long-term negative effect on their ability to carry out normal activities. Select one of the following.
Please detail below any important medical information that our coaches/Junior Coordinator should be aware of (e.g., epilepsy, asthma, diabetes etc.)
Emergency Contact Name 1
Please insert the information below to indicate the person(s) who should be contacted in event of an incident/accident.
Emergency Contact Details 2
Please insert the information below to indicate the person(s) who should be contacted in event of an incident/accident.
Emergency Declaration
Emergency Contact Information Update
Affiliation Declaration
Breakaways Netball Kit Declaration
Photography / Film Declaration
Select 1 of the above options. Breakaways netball is committed to the protection of children and vulnerable adults involved in sport. In accordance with our Child and Vulnerable Adults Protection Policy and Procedures, where possible we will not permit photographs, film, video or other images of children or vulnerable adults to be taken or used without the consent of the child/vulnerable adult and their parents/guardians or carers. Breakaways Netball will take all reasonable measures to ensure any images are used solely for the purposes for which they are intended. If you become aware these images are being used inappropriately you should inform the Club Child Protection Officer immediately.
Acknowledgment of Policies
You can view the Policies here.