Section 1 - Type of MembershipPlease insert total fee for type of membership required

Male Full Playing
Includes social membership for partner and non-playing children under 18 at same address / Membership Fee £180
(-£20 if paid in full by 30th April 2018) / £
Male Student Playing
In full time education as at 1st April 2018 / Membership Fee £90
(-£10 if paid in full by 30th April 2018) / £
Female Full Playing
Includes social membership for partner and non-playing children under 18 at same address / Membership Fee £70
(-£10 if paid in full by 30th April 2018) / £
Female Student Playing
In full time education as at 1st April 2018 / Membership Fee £35
(-£5 if paid in full by 30th April 2018) / £

Playing Experience- Please advise us below of any previous clubs and your cricketing ability

e.g. bat, bowl, keep etc.

Membership Cards will not be issued immediately as Eastcote Cricket Club is in the process of changing its Membership Card system.

TOTAL

Please send this form to June Roan, 1 Downview Road, Findon Village, West Sussex BN14 0UU
Preferred method of payment is online to
Eastcote Cricket Club:
Sort Code 60-07-25, Account Number 66930030, Ref (your name)
Cheques will be accepted payable to Eastcote Cricket Club.
Card payment at the bar.
We do not advise you to pay by cash. DO NOT post cash or leave behind bar. / £

Data Protection: The Club will use the information provided on this form (together with other information it obtains about the member) (together “Information”) to administer his/her cricketing activity at the Club and in any activities in which he participates through the Club and to care for and supervise activities in which he/she is involved. In some cases this may require the Club to disclose the Information to County Boards, Leagues and to the England and Wales Cricket Board. In the event of a medical issue or child protection issue arising, the Club may disclose certain information to doctors or other medical specialists and/or to police, children’s social care, the Courts and/or probation officers and, potentially to legal and other advisors involved in an investigation.

As the person completing this form, you must ensure that each person whose information you include in this form knows what will happen to their information and how it may be disclosed.

Section 2 – Personal details for member:

Name:
Date of Birth:
Home Address & Postcode:
Email Address:
Home telephone:
Mobile telephone:

Section 3 – Personal details for partner:(not applicable for Student members)

Name:
Date of Birth:
Email Address:
Mobile telephone:

Section 4 – Volunteering

Volunteers are a very important part of what makes Eastcote CC successful..There are many areas where the club requires a variety of skills from assisting with the website, fundraising, maintenance of the clubhouse, etc. So if you have a profession, skill or trade and you’re willing to volunteer some of your time, please let us know in the boxes below.

Bar / Teas/Catering / Scoring / Umpiring
Manage/Organise / Fundraising / Other (please specify)
Colts’ Squad Coaching* / Colts’ Friday Night Coaching* / *If you are interested in coaching, please contact Marc Broom

Section 5– Membership Agreement

Please tick each box where you agree (or delete if you do not agree)

I agree that I shall be bound by the Constitution and Rules of the Club, and agree to the Club Code of Conduct
I agree that I will regularly update my match availability on the Eastcote CC website
Signature / Date: