Junior Registration Form

Braves Junior Registration Form

NAME                                                 NOTE : THIS FORM IS FOR PRINTING THEN POSTING OR FAXING
Surname:
First name:    Date of Birth:

We will endeavor to place players in teams with their friends, if this is important then supply 1 playing friend's name:

If more than 1 child fill in below:
First name: Date of Birth: Friend's name:
First name: Date of Birth: Friend's name:
First name: Date of Birth: Friend's name:

HOME
Address: Suburb: Postcode:
Phone: Email contact:

DAD
Name: Work phone: Mobile:
Occupation: Has Dad played cricket before? Yes / No
You don't need any cricket experience to answer the following... Can Dad help out at all? Yes / No

MUM
Name: Work phone: Mobile:
Occupation: Has Mum played cricket before? Yes / No
You don't need any cricket experience to answer the following... Can Mum help out at all? Yes / No

EMERGENCY
Contact Name: Phone: Mobile:
Family Doctor: Phone:
Any conditions/illnesses that we should know about: (mention child names in description)

OTHER DETAILS
If any other detail is needed then please mention below: ie. joining from another club, need "clearances", Uncle Tony loves cricket and would like to help!", cannot make training until 5.30, etc.

SUBSCRIPTIONS
Check website for current membership fees
□ Either send cheque made out to Baden Powell Cricket Club to: 3 Seaview Rd., Frankston South 3199

□ If you would like to pay by Direct Debit then goto "How to pay" page on web (via. membership)

AUTHORISATION
I being the parent/guardian of the above children do agree that I would like my son/daughter to participate in cricket with the Baden Powell Cricket Club. In the event of a medical emergency I authorise the Baden Powell Cricket Club or their representative to contact the names above and if unsuccessful to seek other medical attention as deemed necessary.
Signed:

Forward this form by either post to: Baden Powell Cricket Club to: 3 Seaview Rd., Frankston South 3199
or fax to: 03 9770 6572