Membership Registration Form 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 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. Senior CricketUnder 16Under 14Under 12Under 10 Do you consent for images of the above named player to be used for the purposes of promoting the Wistow Cricket Club.?YesNo
