Earby Cricket Club 16 to 18 Playing Membership Form 2024 Season-Earby Cricket Club

Earby Cricket Club 16 to 18 Playing Membership Form 2024 Season

Benefits of Membership : PAY AS YOU PLAY - Membership Fee - £10 per match (Match Fee) ANNUAL 16 TO 18 PLAYING MEMBERSHIP - Membership Fee - All Match Fees Included

First Name

Last Name

Date Of Birth

Address

Emergency Contact Details - Name

Emergency Contact Details - Address

Emergency Contact Details - Phone Number

Membership Type

Payment Type

MEDICAL INFORMATION

Please detail below any important medical information that we need to know and which would be affected by your participation in cricket activities. Such as: allergies; medical conditions (for example -epilepsy, asthma, and so on); current medication; special dietary requirements, any additional needs, and/or any injuries.

Please indicate if you would like to discuss this privately with us

Please provide details below of any important medical information

I understand that in the event of illness/injury I authorise you to deal with the illness/injury appropriately

IMPORTANT: The data collected is for the purposes of recording & processing your membership application & to send you latest offers & news via our eNewsletter and website. All data is kept secure & it is NOT distributed to ANY third parties.

Your Signature

Date