Queensland Premier Cricket Player Dispensation Form

Player Name

First NameLast Name
Is the player...*

UNDER 1818 or older
Player's Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.
Transfer FROM Premier Cricket Club*
Transfer TO Premier Cricket Club*
Regulation 6(a)(v)(A) requires all player transfer requests to be made before 31 October.

Regulation 6(a)(v)(B) provides an allowance for players under the age of 18 to apply for special consideration to transfer after 31 October if their residential circumstances change.
Regulation 6(e) requires players wishing to play in an additional competition controlled by another Association affiliated with Queensland Cricket to complete a Dual Affiliation Form.
Please advise PRIMARY Association/Club for Dual Affiliation*
This is the player's "HOME" association where registration will remain
Please advise SECONDARY Association/Club for Dual Affiliation*
This is the player's secondary association
Premier Cricket Grade for Finals Eligibility*
Transfer FROM Premier Cricket Grade*
Transfer TO Premier Cricket Grade*
Does this grade transfer affect another player movement?*

YesNo
Please advise any relevant information for consideration*

If no additional information, please type NIL in this box0/0
Should be Empty: