Parley Cricket Club

Membership Form
Please return completed memberships forms via email to andy.neill2@btinternet.com or by post
to; Parley Cricket Club, c/o 6 Olivers Way, Colehill, Dorset, BH21 2LH.

Contact & Personal Details Type of Membership (please tick as appropriate)

Name NEW MEMBERSHIP RENEWAL
Playing Playing
Address Adult Single (18+) 45 Adult Single (18+) 40
Adult Dual 55 Adult Dual 50
Family +1 Playing 50 Family +1 Playing 45
Postcode
Child Child
Email Family +1 Playing 35 Family +1 Playing 30
Home Number Child under 12 Child under 12
Family + Multiple 60 Family + Multiple 55
Mobile Playing Children Playing Children
Date of Birth Family + Playing 70 Family + Playing 65
Adult & Children Adult & Children
Gender
Ladies 35 Ladies 30
Trained First Aider? Non-Playing Non-Playing
Adult Single 35 Adult Single 30
Partners Details (Only applicable for Family or Dual Membership applications)
Adult Dual 40 Adult Dual 35
Name
Date of Birth Payment Method (please tick as appropriate)
Mobile/Tel No. Online Cheque Cash
Trained First Aider? Online transfer to; a/c 11445731 sort code 40-13-07
with Surname and Subs as reference (eg. NeillSubs)
Childrens Details (Only applicable for Family Membership applications)
Details of Playing Children Under-18 Cheques made payable to Parley Cricket Club.
Name Date of Birth M/F
New Members Nomination (Only complete for New Members)
Proposer
Seconder
(Both Proposer & Seconder must have been members for at least 6 months)

Medical Information (Only applicable for Family Memberships) Declaration

Does your child/children have any medical
I/We confirm the details provided are correct and have
conditions, allergies or dietary requirements? read and fully understand the notes contained overleaf.
Yes No
Signed
If YES, please provide childs name and details below; (Your signature)

Signed
(Partners signature)

Date
Note: For applications submitted electronically, typing your name in the
signature box above will be considered your signed declaration.
Additional Notes

Membership fees will be set annually and agreed by the Management Committee or
determined at the Annual General Meeting. Fees are to be paid annually by 31st May, no
player will be selected who has not paid his/her membership in full by the 15th June.

- By completing this form you are also applying for Membership of Parley Sports & Social Club
- The applicant(s) agree to abide by the club rules at all times
- The applicant(s) should understand that full membership only becomes effective after it has been agreed by the full
Management Committee
- Membership cards will be issued after agreement of the full Management Committee
- Membership cards should be carried at all times whilst on the club premises
- Membership cards must be shown on request by the club secretary, other committee members or members of staff.
Failure to do so may result in you being asked to leave.
- In the event of an unsuccessful application, the fee will be returned.
- All details will only be used for club purposes as agreed by the Management Committee
- By signing this application I/We agree to the above terms and conditions and with to apply for membership of Parley
Sports & Social Club. I/We agree to my/our details being posted on the club's notice board prior to consideration of
this application.

Note: Current members of Parley Sports & Social Club wishing to join Parley CC as a playing member will be
required to pay an annual subscription to Parley CC which will be the difference between their current Sports Club
subscription and the relevant fee above.

If you are applying for Family Membership, by signing this form;

- I/we agree to my/our son(s) / daughter(s) / child / children in my care, taking part in the activities of the club.
- I/we give consent to the use of photography in coaching of cricket in respect of my/our child/children (more details
are available from the Club Welfare Officer)
- I/we understand that I/we will be kept informed of cricket activities at the club (eg. timing and transport details for
away matches when my/our child/children is/are involved.
- I/we understand that in the event of injury or illness, all reasonable steps will be taken to contact me/us and to deal
with that injury/illness appropriately.
- I/we am/are aware that should my/our child/children play for a senior team he may have to share changing and
showering facilities (see Junior Rules)
- I/we am/are aware that I/we may be asked to use my/our car to take children to away matches and I/we confirm
that the insurance and MOT are appropriate
- I/we confirm that I/we and my/our child/children will comply with the clubs rules at all times

Parley Cricket Club has adopted a Child Welfare Policy. This form is being used to ensure that all relevant
areas of the policy are being addressed. The Cricket Club's Junior Rules contains contact details of the Club
Welfare Officer and can be viewed or downloaded from the club's website; www.parleycricketclub.co.uk