Hainault and Clayhall Cricket Club
Type of Membership*: Player Honorary Social Date: __________
Name: ___________________________________
Address: ___________________________________
___________________________________
___________________________________
___________________________________
Date of Birth: ___________________________________
Telephone Number:
- Home ___________________________________
- Work ___________________________________
- Mobile ___________________________________
Email: ___________________________________________
In case of emergency please contact:
Name: _______________________________
Telephone Number: _______________________________
Relationship: _______________________________
Previous Club(s): ________________________________________
(Optional)
Occupation: _________________________________________
Any medical history: ____________________________________
Return form to your Captain or Club Secretary
*check website www.hainaultandclayhall.co.uk for subs