Marieke Carstens

This user has not added any information to their profile yet.

Main Account Holder

Username

Bleedorange

First Name

Marieke

Last Name

Carstens

ID Number

8008040103082

Mobile Nr

0829636223

E-mail Address

carstensmarieke@gmail.com

I agree to abide by the constitution of the club and the Code of Conduct for the use of relevant Astro facilities, as well as the playing regulations of the Western Province Hockey Union.

I agree

I acknowledge that hockey as a sport can be dangerous and that by participating in the sport, all players are exposed to certain risks which could result in injury the player or damage to the player's property. I agree to indemnify Durbanville Hockey Club and waive and release any claim me/my child might have against the Club in respect of that injury or damage.

I agree

I agree to pay my DHC registration fee by no later than 1 April 2024 or will forfeit my playing rights as of 1 April 2024 until I have paid the required registration fee. I agree to pay the balance of my subscription fee by 30 June 2024 or will forfeit my playing rights as of 1 July 2024. I understand and agree that I am liable to pay the FULL subscription fee in the event of any injury or any other reason that may prevents me from playing after 31 May 2024. I understand and agree that I am liable for payment of FULL subscription fees once I have completed my registration form to join DHC. I acknowledge that I am aware of the fact that I may not move to or play for any other club affiliated to WPHU, SAHU or FIH until such time as any outstanding debts with Durbanville Hockey Club has been settled in full and I am in possession of a letter from the Durbanville Hockey Club stating this fact.

I agree

I give permission for Durbanville Hockey Club to take photographs/video of me/my child and for these photo’s to be used in club publications, club social media or in advertising or media publications. This may include the printing of names under photographs.

I agree

Please add my email address to the Newsletter database.

Yes

Please add my number to the DHC Whatsapp group(s).

Yes

Your Players' Details

How many players/dependents are included under your profile?

Age On 1 Jan this year

Mobile

0829636223

Ethnicity/Race

White

Current DHC Shirt Number

132

Highest League/Level Played

Umpire grading?

Signature and T's & C's

Digital Signature

Marieke Carstens

Date

8 January 2024

Place

Durbanville