Cricket Senior Membership Form

Instructions All fields marked with an asterisk * are mandatory. If you are an existing member only complete details that have changed since you last registered If you are a new player please complete all fields. Once complete click "Submit". A confirmation email will be sent to your email address.

Your name *
Membership type *
Please select the type of membership you are applying forAdult playing memberStudent playing member (in full time education under the age of 24 on 1st September this year)
Home telephone number
Mobile telephone number
Your email address *(A confirmation email will be sent to this address)
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Date of birth (NB dates are in US format - mm/dd/yyyy)
Medical conditions Please provide details of any pre-existing medical conditions, alergies etc
Occupation, skills and expertise Do you have specific skills or expertise that might be of use to the cricket club? For example, are you a builder or a plumber?
Communication preferences *
We will use contact details provided to contact you about cricket activities. We may also contact you by email or telephone about other cricket club news and events. We will never knowingly pass your details onto other parties. Please choose your communication preferencePlease contact me about cricket playing and other club news and eventsPlease only contact me about playing cricket
Current educatonal institute If you are a student member please provide the name of the educational establishment you are attending

Declaration I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand Coalpit Heath Cricket Club will reclaim 28p of tax on every £1 that I donated up to 5 April 2008 and will reclaim 25p of tax on every £1 that I donated on or after 6 April 2008.
Gift Aid it? *
Do you want the cricket club to claim Gift Aid on donations made?No, I do not want the cricket club to claim Gift Aid on donations madeYes, I want the cricket club to claim Gift Aid on all donations made
Important Please notify the charity or CASC if you: - Want to cancel this declaration - Change your name or home address - No longer pay sufficient tax on your income and/or capital gains. If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self Assessment tax return or ask HM Revenue and Customs to adjust your tax code.
Your Name *
Today's date *