Membership Form 2018/19
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Address *
Your answer
Suburb *
Your answer
Postcode *
Your answer
Phone Number *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Country of Birth *
Your answer
Shirt Size *
Monash University Student Number
Your answer
Monash University Course
Your answer
Other Monash University Club Memberships
Your answer
Previous Cricket Clubs
Your answer
Is there any time during the season that you will not be able to play during the season?
The Winter season runs from April until August.
Your answer
Membership Type *
Parent / Guardian / Next of Kin - Name *
Your answer
Parent / Guardian / Next of Kin - Phone Number *
Your answer
Medical Details
Check all that apply
Payment Details
Each season, everyone who wishes to play for the Monash University Cricket Club, needs to pay an annual fee to the club. The membership costs are based on your membership type.

Club Membership can be made by Cheque, Cash, or Money Transfer to account below:-
Club Bank Details
Account Name: Monash University Cricket Club
Bank: Commonwealth Bank
BSB: 063-301
A/c No.: 10 461 870


* Note completion of this form does not make you a full member until payment is received.

Declaration of Indemnity *
I hereby declare that I will indemnify the Club, it's committee members and officers of the University in respect of any liability for claims, demands, actions or proceedings whatsoever made or taken against them or any of them arising out of loss or damage to property or personal injury as a consequence of my acts or omissions whilst a member of the club.
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