Toulouse Cricket Club
Le Petit Enguinot, 31480, Brignemont, France
Tel: 06 89 99 44 71
Membership Form/Fiche d’Adhésion
NEW MEMBERS ONLY
Send the completed form to : Mr. Neil WARREN, 40 rue Marcel Pagnol, 31700, BLAGNAC.
(email : ) with the following :-
Cheque to “Toulouse Cricket Club” Medical certificate Passport style digital photo (by email)
Please complete in capitals/Remplir en majuscules
Surname / Nom...... ……. First name / Prénom ...... …
Address in France ...... …
Adresse en France
......
Tel (wk):...... Tel (Hm)......
Mob:...... … e-mail...... ……..
Players only/que les joueurs
Nationality/Nationalité...... …
Date of birth / Né/e le...... Place of birth/ à...... …
2014 Membership Fees / 2014 Cotisation
I the undersigned agree to the terms of membership below and wish to join as: (please tick)
Je soussigné(e) demande à adhérer à l’association en qualité de: (cochez)
¨ 40 € Player Competition (Licence and Insurance Included – eligible to play all games)
¨ 20 € Player Non Competition (Insurance Included – eligible to play friendlies only)
¨ 25 € Player U16 (Counter signature by parent required – Friendlies only)
¨ 10 € Friends of Toulouse CC (Social supporter, non-playing or voting member)
Please find a cheque enclosed for...... € made payable to “Toulouse Cricket Club”
Veuillez trouver ci-joint un chèque de……….€ á “Toulouse Cricket Club”
- All adult players must submit a Doctors certificate stating "non-contra-indication a la pratique du cricket en competition" before their first match each season.
· Note that the club will only apply for your license on receipt of this certificate.
· Without a certificate you are not covered by the clubs insurance and will not be eligible for selection for competitive matches.
· Insurance provides limited cover through injury from bat & ball. You may wish to consider additional personal insurance.
- “As a player, or friend, of Toulouse CC I allow any images I submit, or that are taken of me at TCC games or related events, to be used by the club, e.g. website. “
- 2014 Match fees (home and away): Members (Adults & U16’s) 5€, Non Members 15€
Date...... Signature......