All prospective members of Wisbech Town Cricket and Hockey Club are required to complete this registration
form and return it with payment prior to selection for the league season. All details will be kept in a secure
database with access restricted to authorised club officers only.
SECTION 1: MEMBER CONTACT INFORMATIONTITLE / Mr/Mrs/Miss/Ms (Please circle)
`FULL NAME
ADDRESS 1 / TOWN
ADDRESS 2 / POSTCODE
HOME PHONE / MOBILE PHONE
EMAIL / DATE OF BIRTH
SECTION 2: CRICKET MEMBERSHIP TYPE (See Notes on page 4 for further information).
MEMBER TYPE / DESCRIPTION / FEE / MATCH FEE / Please Tick
SENIOR FULL / Aged 19 years or over on 30th April 2017. Includes weekly outdoor nets session. (NB: Additional fees may apply for other training). / £60.00 / £8.00
CONCESSIONARY / Colts Aged 17-19 years on 30th April 2017, OR seniors in Full Time Education, OR Unemployed OR in receipt Out of Work Benefits. (NB: Proof will be required.) Includes weekly outdoor nets session.
(NB: Additional fees may apply for other training). / £40.00 / £5.00
SENIOR ASSOCIATE / As Senior Full and Concessionary. Associate Member get up to 8 official matches for the season. Includes weekly outdoor nets session.
(NB: Additional fees may apply for other training). / £30.00 / £8.00
SENIOR WITH HOCKEY / 20% discount for any Full Member who is also a fully paid member of the Hockey Section. / £50.00 / £8.00
CONCESSIONARY WITH HOCKEY / 20% discount for any Concessionary Member who is also a fully paid member of the Hockey Section. / £32.00 / £5.00
JUNIOR FULL / Aged between 13 years & 16 years on 30th April 2017 playing in senior games. Includes weekly outdoor nets session. (NB: Additional fees may apply for other training). / £35.00 / £5.00
YOUTH CRICKET / Aged between 7 years & 16 years on 30th April 2017 playing in junior games. Includes weekly outdoor nets session. (NB: Additional fees may apply for other training). / £35.00 / £2.00
JUNIOR OR YOUTH WITH HOCKEY / 20% discount for any Full Member who is also a fully paid member of the Hockey Section. / £29.00 / £5.00
FAMILY DISCOUNT / Family must consist of at least more than one junior member and then 20% discount can be applied to each family member.
NON-PLAYING /SOCIAL / Non-Hockey or Cricket playing member who wishes to use the Club facilities (e.g. the bar) and to attend Club social events. Applies to partners or other relatives of members who regularly use the Club. *See Offer in NB9 page 4 / £15.00 / N/A
EXCEPTIONAL CASE / For exceptional cases of late call ups or due to player shortage and at the discretion of the selection committee. Registration form to be completed but no membership fee is required. Exceptional cases can be used for no more than 3 official games for the season.
(Senior Match Fee: £8.00 or Junior Match Fee: £5.00)
GUEST MEMBER / For players who are registered with other teams but are representing the club in a veterans or mixed competition. Registration form to be completed but no membership fee is required.
(Senior Match Fee: £8.00 or Junior Match Fee: £5.00)
Increase in membership fees:
Atthe Joint AGM of WTCHC, adecision was made to increasemembershipfees by £10 for adults and £5 for juniors. However, eachmember (other than Social/Non-Playing members), willhavethechance of recovering theincrease, as they will receive some draw tickets that they can sell to the value of £10 for adults and £5 for juniors.
These tickets will be entered intothe Annual Prize Draw to be held in December 2017 - 1st prize £300, 2nd £150 and 3rd £50.
Membershave the following options:
· Retain the draw entry in their own name (or in the name of parent/guardian if not age 18 or over) – completing and returning the ticket stubs to N Ward/Lisa Jackson/ Nigel Lowe; OR
· Sell the tickets (to persons aged 18 or over) - completing the ticket stubs with the purchaser’s name and returning to N Ward/Lisa Jackson/ Nigel Lowe
Club fundraising can be boosted further by purchasing and selling additional tickets - completing the ticket stubs with the purchaser’s name and returning to N Ward/ Lisa Jackson/ Nigel Lowe. We are confident you will understand this is a positive solution to boosting ourmembershipincome, whilst also providing a fantastic platform for club fundraising.
SECTION 3: HOCKEY MEMBERSHIP TYPE (See Notes on Page 4 for further information).
MEMBER TYPE / DESCRIPTION / FEE / MATCH FEE / Please Tick
SENIOR FULL / Aged 18 years or over on 1st September 2017. Includes weekly Astro training session. / £90.00 / £10.00
SENIOR CONCESSIONARY / As above and in Full Time Education, Unemployed or in receipt Out of Work Benefits. (NB: Proof will be required.) / £60.00 / £7.00
SENIOR ASSOCIATE / As Senior Full. Associate Member get up to 8 official games for the season. / £50.00 / £10.00
SENIOR WITH CRICKET / 20% discount for any Full Member who is also a fully paid member of the Cricket Section. / £72.00 / £10.00
CONCESSIONARY WITH CRICKET / 20% discount for any Concessionary Member who is also a fully paid member of the Cricket Section. / £48.00 / £7.00
JUNIOR FULL / Aged between 13 years and 17 years on 1st September 2017. Includes weekly Astro training session. / £45.00 / £6.00
JUNIOR WITH CRICKET / 20% discount for any Full Member who is also a fully paid member of the Cricket Section. / £36.00 / £6.00
YOUTH HOCKEY (U13s) / Aged under 13 years on 1st September 2017. Includes weekly Astro training session & occasional opportunities to take part in organised matches. / £35.00 / £3.00
YOUTH HOCKEY (U13s) WITH CRICKET / 20% discount for any Full Member who is also a fully paid member of the Cricket Section. / £28.00 / £3.00
FAMILY DISCOUNT / Family must consist of at least more than one junior member and then 20% discount can be applied to each family member.
TRAINING ONLY / Senior individual who wishes to attend weekly Astro training sessions and hold social (non-playing) membership. This category excludes matches (if required transfer to Associate member or treat as Exceptional Case). / £30.00 / N/A
NON-PLAYING/ SOCIAL / Non-Hockey or Cricket playing member who wishes to use the Club facilities (e.g. the bar) and to attend Club social events. Applies to partners or other relatives of members who regularly use the Club. *See Offer in NB9 page 4 / £15.00 / N/A
EXCEPTIONAL CASE / For exceptional cases of late call ups or due to player shortage and at the discretion of the selection committee. Registration form to be completed but no membership fee is required. Exceptional cases can be used for no more than 3 official games for the season.
(Senior Match Fee: £10.00 or Junior Match Fee: £6.00)
GUEST MEMBER / For players who are registered with other teams but are representing the club in a veterans or mixed competition. Registration form to be completed but no membership fee is required.
(Senior Match Fee: £10.00 or Junior Match Fee: £6.00)
Increase in membership fees:
Atthe Joint AGM of WTCHC, adecision was made to increasemembershipfees by £10 for adults and £5 for juniors. However, eachmember (other than Social/Non-Playing members), willhavethechance of recovering theincrease, as they will receive some draw tickets that they can sell to the value of £10 for adults and £5 for juniors.
These tickets will be entered intothe Annual Prize Draw to be held in December 2017 - 1st prize £300, 2nd £150 and 3rd £50.
Membershave the following options:
· Retain the draw entry in their own name (or in the name of parent/guardian if not age 18 or over) – completing and returning the ticket stubs to N Ward/Lisa Jackson/ Nigel Lowe; OR
· Sell the tickets (to persons aged 18 or over) - completing the ticket stubs with the purchaser’s name and returning to N Ward/Lisa Jackson/ Nigel Lowe
Club fundraising can be boosted further by purchasing and selling additional tickets - completing the ticket stubs with the purchaser’s name and returning to N Ward/ Lisa Jackson/ Nigel Lowe. We are confident you will understand this is a positive solution to boosting ourmembershipincome, whilst also providing a fantastic platform for club fundraising.
SECTION 3: MEMBER INFORMATION (Information will be used for club development purposes only)
EXISTING HOCKEY MEMBERS – Please state your shirt number
STUDENTS – What school/college or university do you attend?
NON-STUDENTS – What is you occupation?
Would you be interested in learning to coach and or umpire?
Would you be interested in being a volunteer, team manager or club officer?
Do you (or parent/guardian or close family member) have any skills that could help with the current and future development the club?
(For example – website management & design, media skills, accounting, legal services, insurance, printing, planning, sponsorship, etc). We would really appreciate details of any personal connection that may be able to volunteer their time, or provide support, services or resources.
SECTION 4: MEDICAL INFORMATION (To be completed by PARENT or GUARDIAN if under 18)
In case of emergency and as part of the clubs responsibility to its membership, ALL club members are required to complete this medical information form as accurately as possible. Details will be held securely with access restricted to authorised club officers only. Please delete as appropriate where indicated by a * then sign and date at the bottom.
NEXT OF KIN / RELATIONSHIP / MOBILE PHONE
As far as you are aware, are you allergic to anything?
Are you taking any regular medication? If so, for what reason?
In the event of an emergency, where is your medication kept?
Do you have any long term illnesses or injuries?
SECTION 5: DECLARATION/CONSENT (To be completed by PARENT or GUARDIAN if under 18)
Declaration:
Note - It is a requirement of Club policy that parental consent for Under 18’s is provided for participation, transportation and photography.
PARTICIPATION: I consider myself (my child, where applicable) to be physically fit and capable of full participation and agree to notify the club of any changes to the medical information provided. In the event that I am injured (my child, where applicable) I give my permission for the team managers/coaches/captains appointed by Wisbech Town Cricket and Hockey Club to obtain emergency medical treatment on my behalf. I agree to follow instructions, especially where they relate to my safety or the safety of others.
TRANSPORTATION: I consent to my child travelling to venues for matches and training in transport provided by the Club which may include travelling in other players’/ umpires etc. private cars.
PHOTOGRAPHY: In some environments, particularly adult competition it is impossible to control photography by external parties. However, I am aware that there maybe times that photographs and/or footage maybe taken during matches and training sessions by approved agents and/or officers of Wisbech Town Cricket and Hockey Club. Such images shall only be used for publicity/training purposes in accordance with the Club’s Safeguarding and Protecting Young People Policy/Policies and Photography Policy. I give consent for my child to feature in such photos/ images. I hereby only grant approved agents the right to use the images resulting from the photo/film shoots. This includes any reproductions or adaptations of the images for all general purposes i.e. local newspapers, local magazines, other promotional articles (inc. flyers) and the Club’s websites.
By completing this form and paying your membership fees you understand and agree to follow the Wisbech Town Cricket and Hockey Club Rules & related Notices of the Club, Codes of Conduct, Safeguarding and Protecting Young People Policy/Policies and the Social Media Policy.
I agree to update to notify the Club of any change in respect of my contact details.
I confirm I have read the additional information on Page 4 and will use the blank space on that page to provide any further relevant information.
SIGNED / DATE
RELATIONSHIP
ADDITIONAL INFORMATION TO SUPPORT MEMBERSHIP QUERIES AND CLUB POLCIIES
NB1: Payment
All players are required to settle their membership payment by the deadlines stated. Players who have not paid their subscription will be unavailable for selection after these dates. Any instances of genuine financial difficulties should be discussed in confidence with the Membership Secretary/the Treasurer and their decision will be final regarding any special payment agreements.
NB2: Membership Subscriptions by Bank Transfer (BACS)
Payments can be made electronically to the Club’s account as follows:
Name - WTCHC General Account
Account – 80976954
Sort Code – 20-97-34
Reference – Surname/Subs
NB3: Senior Associate
If a Senior Associate exceeds the 8 games then they should transfer to a Full membership (or Concessionary if applicable).
NB4: Unforeseen Circumstances
The Club does not ordinarily reimburse subscriptions. If due to unforeseen circumstances only a very small number of games have been played the person may submit a written request to the Membership Secretary/Treasurer for consideration of their Subscription to be held over towards the next season’s Membership. Each case would be considered on its own merits before any agreement towards reimbursement is reached.
NB5: Match Fees
Any person who is selected for a match having not paid their previous week’s Match Fee must settle their overdue fee with the Team Captain ahead of the game and have the Match Fee available for that day’s game, or they will be liable for an extra 50% on their Match Fee until they have settled the amount in arrears. Consistent offenders will have to report to the Treasurer and may be excluded from selection.
NB6: Hockey Training
All Hockey membership types apart from Non-Playing and Exceptional Cases are entitled to attend the weekly Astro training but there will be additional fees for other training i.e. Indoor sessions.
NB7: Concessionary – Proof Requirements.
For Full-Time Education we will require production of College/University Identification Card, Student Cards will not be accepted.
For Out of Work Benefit we will require production of a benefit entitlement letter.
NB8: Exceptional Case
If an Exceptional Case exceeds the 3 games then they should transfer to either an Associate or Full membership.
NB9: Club Offer - Non Playing/ Social Membership
Non-Playing/ Social Membership is now granted for free by the Club to any person subscribing for a minimum of 12 months to the WTCHC 100 Club Lottery. We would encourage all those considering Social Membership to join our monthly Lottery as an alternative. Forms are available at the Club or please contact Josh Anderson (Club Lottery Coordinator) Or Ali Mason (Promoter/Treasurer).
NB10: Insurance
Whilst the Club holds liability insurance for its business activities, including the activities connected to the playing of cricket and hockey, it is not responsible for the personal liability of its members, nor does it provide personal accident insurance cover. The club accepts no responsibility for money or personal belongings of members, members’ guests or visitors left on the Club premises, including lost property held by the Club.
The Club strongly recommends all members, volunteers and players take advice and review their own insurance arrangements in respect of personal liability, personal accident and personal belongings. If any further information is required regarding this subject, please contact Ali Mason (Treasurer).
PLEASE USE THE SPACE BELOW TO DISCLOSE OR ADVISE OF ANY FURTHER RELEVANT INFORMATION:
FOR WISBECH TOWN CRICKET AND HOCKEY CLUB USE ONLY:
DATE OF REGISTRATION: / PAYMENT AND METHOD : / DATABASE INPUT: / DRAW TICKET NUMBERS:
COMMENTS:
Wisbech Town Cricket and Hockey Club Registration Form – AUGUST 2017