KCC Senior/Social Application Form 2018
Membership Form for KCC Seniors
Please enter your full name
Please enter your address with comma's between each line
Please enter post code with a space in the middle
Date of Birth
Please enter a mobile number
Preferred Selection Contact Method
Emergency Contact Name
Emergency Contact Number
Provide details of any medical conditions that the Club should be aware of (Optional):
Please enter "None" if no medical conditions or you do not wish to declare
Predominant Skill Level and further details: (Please tick all appropriate boxes)
Batsman - Right Hand
Batsman - Left Hand
Bowler - Fast
Bowler - Medium
Bowler - Off Spin
Bowler - Leg Spin
I am a qualified cricket coach
I have been DBS Checked
I would like to assist with junior coaching
I would like to assist with the administration of the club
Playing Preferences: (Please tick all appropriate boxes)
Sunday (There may be a few games on Sundays, mainly friendlies)
Saturday and Sunday
I can play Midweek Evenings
I can only play occassionally
Social Member Only
Please tick the box below to agree to club policies
I agree to abide by the Club Constitution, the Club Code of Conduct and Club Policies as adopted.
If paying by bank transfer, please use your name as the reference and tick the box below. Sort Code: 30-94-55 Account Number: 00169502
Full - £70 (£60 if paid before 1 May)
Intermediate - If you not working or in full time education £35 (£30 if paid before 1 May)
Social - £5
Social - Free (|My child is a Junior Member, name supplied below)
Name of Junior (For Free Social Membership)
Would you like to sponsor a match ball this year?
Yes (Please add £10 to your membership fee) Thank You
No, maybe next time!
Intended Payment Method
Please make every effort to pay as soon as possible
Bank Transfer (Preferable) Please email our treasurer Mike Pratt if you pay by Bank Transfer to let him know at
Cheque (Made Payable to "Kesgrave Cricket Club"
Cash (Please ask for a receipt from the person you pay)
Regular Monthly Payment agreed with Treasurer
Make sure you keep up to date
Please make sure you sign up to the club website. Also, please like our Facebook page, follow our twitter page and sign up to the mobile app. Details are all on the website.
Please be advised that information provided on this form may be stored on a computerised system for use by Kesgrave Cricket Club and in accordance with the latest Data Protection Act.
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