COPDOCK AND OLD IPSWICHIAN CRICKET CLUB
SENIOR SECTION MEMBERSHIP APPLICATION FORM 2018
Your Details:(please complete details on next page for any additional junior or immediate family members to qualify for any family discount)
Forename: ...... Surname: ……………......
Address:, ......
………………………………......
Postcode: ...... Home Telephone No ......
Work Telephone No ………………………………..
Mobile No: ....………...... Email ......
Next of Kin contact details
Name:………………………………………………… Relationship:......
Telephone:...... Mobile......
EMail address: ……………………………………………………………………………
Medical History
Please detail any medical condition or disability you feel the club should be made aware of in relationship to your participation in Cricket:
………….………......
Additional information
Please detail any additional information you think we need to know
……………………………………………………………………………………………………………………………………......
Name of additional junior family member (1) …………………………………………………….
Name of additional junior family member (2) …………………………………………………….
Name of additional junior family member (3) …………………………………………………….
Name of additional junior family member (4) …………………………………………………….
Relationship to you (Son, Daughter Spouse only)
……………………………………………………………………………..
Membership forms can be scanned and sent electronically, or attached as a word or pdf document, to:
Membership Secretary–
or posted to:-
Subscription FeesFull playing Member£55
Unemployed£40
Student 16+£40
Ladies£45
Social£30
Senior Match Fees
Adult Match Fee / £12 per gameAll others playing in a senior match / £8 per game
Midweek T20 Match Fee / £5 per game
To support the growing family element within the Club the following retrospective discounts will apply for those with children in the junior section:
Second member-5% discount on total paid
Third member-10% discount on total paid
Fourth member-12% discount on total paid
Additional Voluntary Donation
Membership fees are currently kept at a level to maximise the number of children, teenagers and adults who are able to enjoy playing cricket throughout the season at the club. Whilst we have been very successful in that aim, there does unfortunately continue to be pressure on the Club’s finances when it comes to meeting larger one off expenses particularly for ground maintenance equipment.
To help relieve some of that pressure, we are asking members if they might also like to make a voluntary contribution towards the Club’s funds. There is no pressure at all to do so, it is entirely voluntary, but any level of donation would be very much appreciated. Just £10 per member would raise over £2,000, for instance, and £25 over £5,000.
Many thanks for considering whether you might do so.
PAYMENT DETAILS
Our preferred method for all payments is by Internet Banking
Please reference your payment clearly with your name
Our Bank Details are: Copdock & OI CC 20-44-51 03911403.
To confirm your eligibility to play in the 2018 season, the club must be in receipt of your membership payment, £55 in full (or as per Discount table), by Internet Banking, (BACS), or you will not be selected to play
I will be making a payment of £…………………. To cover membership fee/s as detailed above.
I will be making a payment of £…………………. As an additional donation to the Club.(Complete Gift
Aid Form if appropriate)
TOTAL Payment £………………….
Payment by:Internet Banking (BACS)
Gift Aid Formattached
If internet banking is not an option for you please contact us
Please note we can also accept payments at by Debit Card
If you wish to pay by Debit Card at any time via the internet, please email our accounts section d we can email you a link with which to make your payment securely.
For further information please visit our website:
Gift Aid declaration – for past, present & future donations
Copdock and Old Ipswichian Cricket Club
Please treat as Gift Aid donations all qualifying gifts of money made
today in the past 4 years in the future
Please tick all boxes you wish to apply.
I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 28p of tax on every £1 that I gave up to 5 April 2008 and will reclaim 25p of tax on every £1 that I give on or after 6 April 2008.
Donor’s details
Title ------First name or initial(s) ------
Surname ------
Full home address ------
------
Postcode ------
Date ------
Signature ------
Please notify the CASC if you:
Want to cancel this declaration
Change your name or home address
No longer pay sufficient tax on your income and/or capital gains.
If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self Assessment tax return or ask HM Revenue and Customs to adjust your tax code.