Amersham CC and Cricket Vision Summer Camp Registration
Please pay either by cheque made out to “Amersham Cricket Club” or by bank transfer to Amersham Cricket Club, details are the following: Account Number: 49041560, Sort Code: 30-90-38. If you have any questions about the camps please do not hesitate to contact Ian Rogers (Chairman of Amersham Cricket Club): ianis@theoldswanagain.co.uk / 07778706179 or Tim Doughty (Director of Cricket Vision): tim@cricketvision.co.uk / 07810468241 or Ben Doughty (Director of Cricket Vision): ben@cricketvision.co.uk / 07818275098
Son/Daughters Full Name *
Your answer
Son/Daughters Date Of Birth *
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DD
/
YYYY
Parents Full Name *
First and Last name
Your answer
Parents Email *
Your answer
Parents Phone Number *
Your answer
Which days do you want to attend? *
If you are coming to all days select 'All Days'. If you would like to book individual days use the other options.
Required
Is your son/daughter a:
Does your son/daughter have any allergies? *
If you answered yes to the last question please give details: *
If you answered no just put N/A in the box below.
Your answer
Please give any medical history that we should be aware of
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Emergency Contacts - Please provide two different emergency contacts! *
Email address and Phone number
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Would you like to be put on Cricket Vision's mailing list? *
We only email out special offers, private coaching and camp news.
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