St Albans Cricket Club
2022/23 Registration
By submitting this form you are agreeing to the terms and conditions of membership. Your details will be included in the New Zealand Cricket national participant database. Access to personal data is firmly restricted to specific club, association & national administrators. Contact us if you have any difficulties completing this form.
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MEMBERSHIP CATEGORY

Adult Membership
Student Membership
Non-playing Membership

AVAILABILITY

PLAYER CONTACT DETAILS

First Names(s): Surname:
Street Address: Suburb: City/Town: [lookup postcode]
Home Phone:
Mobile:
E-mail Address:

PERSONAL DETAILS

Gender: Date of Birth:   
Ethnicity: (select 1 or more)
Allergies/Conditions: (optional)

EDUCATION/FAMILY/NOTES

School Name: School Year:
Primary Parent/Guardian Details:

(This will be used as the primary emergency contact)

First Name: Surname: Relationship to Player: Email: Mobile:
Availability to Assist:
   
 
Secondary Parent/Guardian Details: (optional)
First Name: Surname: Relationship to Player: Email: Mobile:
Availability to Assist:
   
 
Name of Institution: Student ID Number:
Additional Notes: (optional)

REGISTER & PAY


SUBSCRIPTION PAYABLE $0.00

You must pay your subscription in full BEFORE November 30 or have begun an automatic payment to our account before this date.

If a payment method is not set up prior to this date, you will be ineligible for selection until an arrangement is made.

To pay your subscription via direct credit or to set up an automatic payment, our account is:

03-0802-0091696-00

Include your Name as the reference so we can identify you.

Automatic payment options:

  • monthly (x4)
  • fortnightly (x8)
  • weekly (x16)
SUBSCRIPTION PAYABLE $0.00
Card type: Name on card: Card number: --- Card expiry: