Junior Membership Form Junior Membership This form is for new and returning junior members. By completing a membership form, you will be eligible to play for Newcastle Cricket Club teams, and will pay the reduced weekly rate of £5 per training session (Normal social cost is £8).Childs detailsMember Name* First Last Date of Birth* DD slash MM slash YYYY School Year*Regrettably, we can only accept Junior Members from Year 2 and above.2345678910111213Your child will be eligible to play for the U11 TeamYour child will be eligible to play for the U13 TeamYour child will be eligible to play for the U15 TeamChild's Address* Street Address Address Line 2 City ZIP / Postal Code Childs Medical Details Please disclose any medical conditions your child has that we should know about.Condition Asthma Diabetes Epilepsy Nut Allergy Other medical conditionDoes your child have a disability? Yes Nature of the disability?Junior Player Price: Add a second child? Tick to add Second Childs detailsMember Name* First Last Date of Birth* DD slash MM slash YYYY School Year*12345678910111213Your child will be eligible to play for the U11 TeamYour child will be eligible to play for the U13 TeamYour child will be eligible to play for the U15 TeamChild's Address* Same as First child Street Address Address Line 2 City ZIP / Postal Code Childs Medical Details Please disclose any medical conditions your child has that we should know about.Condition Asthma Diabetes Epilepsy Nut Allergy Other medical conditionDoes your child have a disability? Yes Nature of the disability?Additional Junior Player Price: Add a third child? Tick to add Third Childs detailsMember Name* First Last Date of Birth* DD slash MM slash YYYY School Year*12345678910111213Your child will be eligible to play for the U11 TeamYour child will be eligible to play for the U13 TeamYour child will be eligible to play for the U15 TeamChild's Address* Same as First child Street Address Address Line 2 City ZIP / Postal Code Childs Medical Details Please disclose any medical conditions your child has that we should know about.Condition Asthma Diabetes Epilepsy Nut Allergy Other medical conditionDoes your child have a disability? Yes Nature of the disability?Additional Junior Player Price: Add a fourth child? Tick to add Fourth Childs detailsMember Name* First Last Date of Birth* DD slash MM slash YYYY School Year*12345678910111213Your child will be eligible to play for the U11 TeamYour child will be eligible to play for the U13 TeamYour child will be eligible to play for the U15 TeamChild's Address* Same as First child Street Address Address Line 2 City ZIP / Postal Code Childs Medical Details Please disclose any medical conditions your child has that we should know about.Condition Asthma Diabetes Epilepsy Nut Allergy Other medical conditionDoes your child have a disability? Yes Nature of the disability?Additional Junior Player Price: Parents detailsParents Name* First Last Phone*Email*Thank you for providing your email address – posting less keeps costs down and is better for the environment. We send occasional e-newsletters etc and use it to contact you if necessary. We do not share members’ email addresses with third parties. Enter Email Confirm Email Parents Address Same as child's address Street Address Address Line 2 City ZIP / Postal Code Second Parents Name(Optional) First Last Second Parents Phone(Optional)Second Parents Email(Optional) Enter Email Confirm Email Permission for Photography/Video*On occasions Newcastle Cricket Club takes photo/video for communications and publicity purposes. Please indicate whether you are happy for your child to be included. Yes, photography is fine No, please exclude my child Email information listWe send out several member information emails over the course of a season to keep you up to date with the club's affairs. We will never give your email address out to a third party or spam you with emails not pertinent to club affairs. If you are set against receiving emails from the Club, please tick the box below but understand that you may miss vital information as a result. It will be your responsibility to check the noticeboard in the bar for any important information. You can also unsubscribe at any time. No, please do not send me any information emails Declaration*Newcastle Cricket Club will never pass your details on to a third party without your knowledge and explicit consent. Your details will be stored securely on a server hosted within the UK. By ticking this box in lieu of a signature, I consent to Newcastle Cricket Club storing the details I've given above securely and only for the purpose of providing the services for which I am applying. I also agree to the child in my care taking part in the activities of Newcastle Cricket Club. I understand that in the event of an injury or accident, all reasonable steps will be taken to contact me and to deal with any injury/illness appropriately. I undertake, if accepted, to observe strictly and to abide by the Rules, Bye-Laws and Codes of Conduct of the Club – supplied to me and on Club Noticeboard in Pavilion Bar and on website. I understand these rules apply to my children as well and will ensure they also abide. Total to pay £ 0.00 This field is hidden when viewing the formTag Senior Membership Form Senior Membership New or Renewal?*Please indicate if this is a new membership or a renewal of last season's membership. Please note, if you have lost your membership card, please complete this as a new membership. New Member Renewal Membership type?*Which membership type are you applying for? All cricket playing memberships are half price till the end of the season. Mens Senior Player Womens Senior Player Student Player Social Voting Social Non-voting Social Student Team?*First TeamSecond TeamThird TeamAcademy TeamWomens TeamExisting Standing Order MembersTick this box if you already pay by Standing Order. I already pay by standing order Your membership for this season should already have come out of your account in January. As such, we are honouring that amount for this year's membership renewal. However, our bank accounts have changed and we need you to cancel the Standing Order in place and create a new Standing Order using the detail below. Because you have already paid, please set it up to come out on 1 March 2019 for the amount applicable to this year's membership rates. Payment must be made payable to: Newcastle Cricket Club Barclays Bank Plc 104 Shields Rd Newcastle Upon Tyne NE6 1HR For Player and Voting Social Memberships, pay in to: Sort Code: 20-59-59 Account Number: 53342727 For Student Social and Non-Voting Social Memberships, pay in to: Sort Code: 20-59-59 Account Number: 43827720 New Standing Order MembersTick this box if you would like to pay by Standing Order. Please ensure you check the total amount to set up your Standing Order for, especially if you are including your partner/spouse. I want to pay by Standing Order It is your responsibility to set up a Standing Order with your bank with the first payment to be paid immediately (unless you have an existing Standing Order which has already come out for this season), and then subsequent payments to be made on the 1 March on a yearly basis. Your membership will not be processed until we have received the Membership payment for this year. Payment must be made payable to: Newcastle Cricket Club Barclays Bank Plc 104 Shields Rd Newcastle Upon Tyne NE6 1HR For Player and Voting Social Memberships, pay in to: Sort Code: 20-59-59 Account Number: 53342727 For Student Social and Non-Voting Social Memberships, pay in to: Sort Code: 20-59-59 Account Number: 43827720 Name on Standing Order Account*Please ensure you complete this so we can link your membership with Standing Order payment First Last Personal DetailsName* First Last Existing Card Number*Please fill in your existing NCC Card Membership numberEmail*Club communication is by email only. All important club communication will posted on the noticeboard in the bar as well as emailed out but we no longer post info out to save on costs so if an email is not provided, you will not receive any club information. Please note, you must provide an email address to sign up online so we can email you confirmation. If you do not have an email address, you will have to fill in a paper form and pay at the club. Enter Email Confirm Email Do you need to update any info?If you have moved house or changed any contact details, please tick the items you want to update. Otherwise we will use the details from last year. Address Phone Address* Street Address Address Line 2 City ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Please supply a mobile phone if possible.Date of Birth* DD slash MM slash YYYY Student NUC Card*Please take a photo of your NUC card and upload it as either jpg, or png. This is to verify your student status. Please ensure the name and photo are clearly visible on it.Accepted file types: jpg, jpeg, png, Max. file size: 20 MB.Add/Renew your Partner/SpouseDiscounted spouse/partner membership can only be processed with this application. If applied for separately, full membership will have to be paid for. Your spouse will have the same membership type as yours. I want to apply for renew my partner/spouse as well Partner/Spouse Name* First Last Do you need to update any of your partners info?If you have moved house or changed any contact details, please tick the items you want to update. Otherwise we will use the details from last year. Address Phone Email Partner card statusPlease indicate whether your partner has a card to reactivate, or needs a new card issued New Card Required Existing Card Reactivation Partner/Spouse Existing Card Number*Please fill in your existing NCC Card Membership numberPartner/Spouse Address* Same as partners Street Address Address Line 2 City ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Partner/Spouse Address Change* Same as partners Street Address Address Line 2 City ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Partner/Spouse Phone*Partner/Spouse Phone Change*Partner/Spouse EmailClub communication is by email only. All important club communication will posted on the noticeboard in the bar as well as emailed out but we no longer post info out to save on costs so if an email is not provided, you will not receive any club information. Enter Email Confirm Email Partner/Spouse Email ChangeClub communication is by email only. All important club communication will posted on the noticeboard in the bar as well as emailed out but we no longer post info out to save on costs so if an email is not provided, you will not receive any club information. Enter Email Confirm Email Partner/Spouse Date of Birth* Day Month Year Mailing listWe send out several member information emails over the course of a season to keep you up to date with the club's affairs. We will never give your email address out to a third party or spam you with emails not pertinent to club affairs. If you are set against receiving emails from the Club, please tick the box below but understand that you may miss vital information as a result. It will be your responsibility to check the noticeboard in the bar for any important information. You can also unsubscribe at any time. No, please do not send me any information emails Additional DonationNewcastle Cricket Club is a CASC (Community Amateur Sports Club) run mainly by volunteers. The money we raise is to support sport participation and community involvement. We very much appreciate any additional donations – thank you! Gift Aid DeclarationIf you are a UK taxpayer (income or capital gains), you have the option to “Gift Aid” any financial donation you make. This means Newcastle Cricket Club can receive extra funds at no greater cost to yourself. (If you are unsure whether your donations qualify for Gift Aid tax relief, please check on www.hmrc.gov.uk.) I want the CASC (Community Amateur Sports Club: Newcastle Cricket Club) to treat all donations that I make from the date of this declaration until I notify you otherwise as Gift Aid Donations. Declaration*Newcastle Cricket Club will never pass your details on to a third party without your knowledge and explicit consent. Your details will be stored securely on a server hosted within the UK. By ticking this box in lieu of a signature, I consent to Newcastle Cricket Club storing the details I've given above securely and only for the purpose of providing the services for which I am applying. I also undertake, if accepted, to observe strictly and to abide by the Rules, Bye-Laws and Codes of Conduct of the Club – supplied to me and on Club Noticeboard in Pavilion Bar and on website. This field is hidden when viewing the formFree MembershipThis is a hidden field which can only be applied by an Admin for a complimentary membership Complimentary Membership Senior Men Player Price: Senior Women Player Price: Senior Student Player Price: Social Voting Member Price: Social Non-Voting Price: Partner/Spouse Member Price: Total £ 0.00 This field is hidden when viewing the formTag
