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Associate Members - Independent (2015)

Please complete this form only if seeking an associate membership for New Zealand Inline Hockey  when intending to either
1. Apply for membership as an independent person not affiliated to a club and not intending to play for an affiliated club or,
2. Special Circumstance and enter a one off event as a player. Note: if subsequent to participation you find you want to continue to compete you will be required to complete the full registration and pay the membership fee through the club you wish to play for.

This form is necessary to allow participation on the understanding that you will abide by the NZIHA rules, codes of conduct and any event rules initiated by the event organiser.

In the event that you do continue to play and seek a full club membership you will need to notify NZIHA by email to have this one off associate membership cancelled. Email address is nz.inline@gmail.com.

All applications to NZIHA made using this form are subject to acceptance by NZIHA. Approved memberships will be confirmed by email to applicant.

Thank you for your co-operation.

Fields marked with are required. 

First name
Last name
Email address
Date of birth
Event being Entered
Team Name (if known)
Please enter the following text in the space below

Terms and Conditions

I agree to abide by the
a) New Zealand Inline Hockey Playing Rules
b) NZIHA Code of Conduct and
c) any other event rules as advised by orgsanisers for the duration of an event I am seeking an associate membership for
d) NZIHA Constitution

Copies of documents can be requestred or found on the NZIHA website ( www.inlinehockeynz.org.nz)

I accept