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Monday, 6 September 2010

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Registration Form

Junior Registration Form 2010 - 2011 Season

First Name :

Surname :

Address :

NickName :

Home Phone :

Date Of Birth : DD/MM/YY

Emergency Phone :

Parents Email :

Mobile Phone :

Your Email :

School Attending :

Current School Year :

Did you play for ERDCC last year ?

Yes
No

Is another family member playing for the Junior Club ?

Yes
No

If yes to above ... What team were you in ?

Siblings Name and Grade

Team Coach

Parents/Caregivers Name :

I can help with :

Team Coach
Team Manager
Scoring
Transport
Care Of Gear

Privacy Act:

- I permit the Eden-Roskill District Cricket Club Inc to use my name and contact details for the purposes of fundraising for the club.

- I understand that my personal details will be provided to the Auckland Cricket Association for the purposes of the player registration.

- I permit our son’s/daughter’s phone number to be recorded on a team contact sheet to be provided to Team members/Parents of Team Members/Club Officials only.

Acknowledgement:

I am aware of the objectives of New Zealand Cricket Inc. and the Auckland Cricket Association Inc. in seeking to ensure that all grades of cricket are played under the guidelines set out in the preamble to the “Laws of Cricket” entitled “The Spirit of Cricket” (overleaf).

I have read and understand this document and agree to abide by the guidelines set down in it in all matches I am involved with, either as a player, coach or as a spectator.

Yes I accept*

Please select to acknowledge acceptance of the above

Fee Schedule (includes team photo):

Y1 – Y2:	$ 90.00	Y3 – Y6:	$135.00
Y7 – Y8:	$150.00	Y9 to UNDER 18	$180.00
	U12 - U19 Girls	$85.00

Shirt required : ($ 30.00)

Yes
No

Shirt Size :

Team Cap Required : ($ 15.00)

Yes
No

Payment Options:

You can come into the clubrooms to pay by Eftpos, Cash, Cheque or Visa.
(5% Surcharge applicable to payments by Visa)
or payment by Electronic Banking,
ASB Three Kings 123086 0103644 00

details will also be sent in your confirmation email.

* Required

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