Membership Registration

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Cricketers Club Membership Form

Email *

PLAYERS NAME *

DATE OF BIRTH *

DD/MM/YYYY

PLAYERS MOBILE *

+263 XXXXXXXXX

GUARDIAN MOBILE *

+263 XXXXXXXXX

GUARDIAN EMAIL *

MOTHERS PHONE *

+263 XXXXXXXXX

MOTHERS EMAIL *

FATHERS PHONE *

+263 XXXXXXXXX

FATHERS EMAIL *

MEDICAL INFORMATION & CONSENT (To be completed by PARENT or GUARDIAN) MEDICAL CONDITIONS – Please specify any condition or allergies *

DECLARATION *

I accept that cricket is a dangerous sport, which by its nature involves a degree of risk of personal injury. I acknowledge that ‘ACHPP Bakers INN Futures League’ cannot ensure complete safety at all times, I therefore accept these risks and agree to be responsible for the involvement of my son. I accept that ‘ACHPP Bakers INN Futures League’ cannot be held liable for any injuries caused to my son or caused to others, due to his participation or involvement in the league. I confirm that I have read the above and I understand the conditions as set out therein.

YES

SIGNATURE *

By entering your name below you are agreeing to the above information

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