2022 Adult Registration

2022 Adult Registration
GPRCC 2022 Membership and Match Costs

Adult member: £105 registration, £15 match fee
Full time education / unemployed: £85 registration, £10 match fee
One-off payment (registration + match fees): £260
Name *

First Name Last Name
Email *
example@example.com
Did you register to play for GPRCC last season? *

Yes No
Have your contact details or medical details changed? *

Yes No

Your Details
Date of birth *

Day Month Year
Mobile Phone Number *

Area Code Phone Number
Home Phone Number

Area Code Phone Number
Address *

Address 1

Address 2

Town County

Postcode
Have you played for any other club in a SNEL Cup, T20 or league match in the 2020 or 2021 seasons? *

Yes No
Which club did you play for?
Do you have a British or EU passport? *

Yes No

Overseas Player Details
Please list all clubs you have played for in UK and overseas with dates *
Are you working whilst in the UK?

Yes No
Please provide details of employment below
Type of VISA or method of entry to UK
Category of registration

Category 3 Overseas Category 3 Overseas Exempt

Category 3 Overseas Exempt
Date of first arrival in the UK at the start of qualifying period for 18 month ordinary resident status *

Day Month Year
Date
Details of any time outside the UK during the previous 18 months. Indicating dates of departure and return *
Details of all addresses in the UK with dates from the time you began to be ordinarily resident. *
Full details of any employment in the UK with dates from the time you began to be ordinarily resident *

Category 3 Overseas
Have you been registered to a Professional or Semi Professional team, including an academy and development age groups, within the last 4 years? *
Have you represented a Nation or National team, including all youth and development age groups from U17 upwards, within the last two years? *
Have you engaged an agent or representative with the aim of finding opportunities as a sportsperson, and/or developing a current or future career as a sportsperson, within the last 12 months.? *

Emergency Contact Details
Emergency contact name and relationship *
Emergency contract number *

Area Code Phone Number

2022 Playing Shirt
GPRCC will be providing a voucher for a playing shirt or other club merchandise to all members who register for the 2022 season.

Once your registration has been processed you will receive an email explaining how to order directly from our online club shop.

Confirmation
Please read the following before pressing 'Next' to proceed to payment.
By submitting this form you are confirming that:
1. I agree with the Gidea Park & Romford Cricket Club terms and conditions as laid down in the club's constitution, its codes of conduct including the England and Wales Cricket Board (ECB) “Safe Hands” Child Protection Policy and any notices that may be displayed within club premises from time to time.
2. I understand that it is my responsibility to arrange personal accident insurance if required and agree that the club and/or its agents cannot be held liable for any loss or damage howsoever caused.
3. I agree and accept that the contact details on this form may be transmitted, either manually or electronically, between club officers for normal club administration purposes and I give consent for these details to be given to the organisations to which the club has affiliated, where reasonable and appropriate.
4. I understand that in the event of any injury or illness to the above named, all reasonable steps will be made to contact my Emergecy Contact and to deal with that injury or illness appropriately.
5. I also give consent to the above named being included in any normal press releases and/or video and/or television and/or team and individual photographs that may be included in any pages on the club’s website and accept that it is my responsibility to notify the club secretary in writing should I wish to withdraw this consent (Secretary's contact details can be found on www.gprcc.co.uk).

Payment

I am registering as: *

Employed £ 105.00

FT Education / Unemployed £ 85.00

Registration and match fees £ 260.00

Total £ 0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

2022 Adult Registration

Your Details

Overseas Player Details

Category 3 Overseas Exempt

Category 3 Overseas

Emergency Contact Details

2022 Playing Shirt

Confirmation

Payment