Membership Registration Form

Season 2021-22 Pricing

Junior Players $100
Registration and Payments are done through MyCricket.

Senior Players $150

To register as a Wistow Cricket Club player please complete the following form.

Player's Name*

Player's Date of Birth (Only required for players aged 16 or under)

Contact Phone Number

Email Address*

Postal Address

Suburb/Town

Post Code

Emergency Contact Details

Emergency contact*

Emergency contact Phone Number*

Medical Conditions

Are there any medical conditions that as a club we need to know about?YesNo

If yes to the above question please provide details including nature of the condition, any medication taken, and any required treatment.

Playing Grade

Please select a playing grade. Please note that for junior grades it is based on the player's age as at 1st September e.g. a player aged 10 on the 1st September is eligible to register for the Under 10's.

Do you consent for images of the above named player to be used for the purposes of promoting the Wistow Cricket Club.?YesNo