2011/2012 Season Registration

If you were a member of Inline Hockey Ireland in years previous, please Login before completing the registration form. If you don't have login credentials, check your email or contact general.secretary@inlinehockeyireland.org

Personal Details

Forename

Surname

Birthdate

Gender

Male Female

Citizenship

Do you hold an Irish Passport?

Yes No

Contact Details

Country

Address line 1

Address line 2

Address line 3

Town/City

County/State

Postcode

Mobile

(incl country code, 353 for Ireland)

Other telephone

(incl country code, 353 for Ireland)

Guardian Information

If you are under 18 years of age, please provide guardian information.

Name

Phone number

(incl country code, 353 for Ireland)

Emergency Contact Details

Please provide details for an emergency contact.

Name

Phone number

(incl country code, 353 for Ireland)

Registration Details

Registration Fee
Registration fees for the season are:
€10 (18 years and older)
€5 (under 18 years)

Payment method

Cheque/Money Order Bank Transfer Credit Card (via Paypal)

If you would like to also register with a club, select below.

Club registration

Website Password

Choose a password for your IHI website account.

Password

Password Confirmation

2011/2012 Season Registration

Past member?