Seniors Registration – Laudium Cricket Club

Please complete the form below to register as senior player

Players Name *First name

Players Surname *Last name

Players ID Number0 / 13

Players Passport Number0 / 13

Date of birth *

Day *

Month *

Year *

Race

Batting

Batting Order

Bowling

Bowling Style

Previous ClubPlease enter the name of the players previous club

Wicket Keeper

Players Phone Number

Players Email Address

Street Address

Apartment, suite, etc

City

Province

Postal Code

School Attending *0 / 50

Upload file *

No file chosen

Please upload a copy of the players birth certificate, passport or registered identity document

Does the Player have any Allergies? if yes, please describe0 / 250

Is the player on any medication? if yes, please state which medication0 / 250

Parents name *

Parents Surname

Parents Contact Number *

Parents Email Address *

Next of Kin - Contact Number

Next of Kin - Name & Surname

Next of Kin Relationship to Player *0 / 30

I agree to pay the fees as selected *The full payment of R1200.00 before the 31 July4 Instalments of R300 payable at the end of July, August, September & October.Other - Only applicable with written consent from the executives

I hereby submit the above information to be true and correct *Agree

Media Consent. Pictures and videos may be captured on and off the field, during matches, training etc. these pictures will be used in our social media, website, promotions etc. if you would specifically like to be excluded, please send an email to info@laudiumcricket.co.za and to social@laudiumcricket.co.za with your detailed explanation. Otherwise it would be taken as this has been accepted. *Agree

I shall at all times be committed to Laudium Cricket Club, to its constitution, code of conduct and to the elected members of the executive. *Agree

I as the Parent / Legal Guardian provide permission to my child also known as the player, To participate in the LAUDIUM CRICKET CLUB (hereafter referred to as the Club), training session and matches, including traveling to and from any of those events at own risk. I hereby unequivocally, being a sound mind, voluntarily that I am aware that playing the game of cricket has inherent risk and voluntarily assume such risks. I hereby absolve, indemnify, and hold blameless the Club in respect of any damages, which my child/ward may suffer, whether bodily injuries and/or any loss of whatever nature. I hereby confirm that the Club is in no manner liable for payment to me, my estate, my successors in title, heirs or any person or institutions for payment of amount whatsoever in respect of damages which my child may suffer arising out of and/or any involvement in any manner by my child in cricket matches, tournaments, practices, or any other activities in which the club is involved and travelling to or from such activities. *Agree