"*" indicates required fields Team Name* Team Address* Street Address City State / Province / Region ZIP / Postal Code Team Contact* First Last Contact Number*Contact Email* Age Group* Seniors Juniors Senior Competition* Saturday Weekly Sunday Weekly T20 Junior Competition* Under 12s Weekly Saturday Under 13s Weekly Saturday Under 13s Saturday T20 U14 T20 Weekly Saturday Grade Preference* First Grade Second Grade Preferred Home Ground(s)*Ground use subject to approval Add RemoveConsent* *As Team captain/manager/or other responsible party named here, I understand that I am solely responsible for ensuring individual registration of players via BOTH wintercricket.net.au and Player Registration via PlayHQ (Particpant Insurance is via PlayHQ Registration ONLY). Teams must be entered within PlayHQ by 10pm the evening preceding match day. Penalties may apply for failing to complete any of the prior requirements.*Signature*Nomination fees can be paid online via PayPal, or via bank transfer/PayID prior to submitting the form. Bank Transfer: Winter Cricket BSB: 670-864 A/C: 18015102 or... PayID: [email protected]Payment Method*Online payments incur a processing fee Pay online Bank transfer / PayID Receipt*Max. file size: 256 MB.Senior Saturday Weekly Team Nomination Fee* Price: Senior Sunday Weekly T20 Team Nomination Fee* Price: Junior Team Nomination Fee* Price: Senior Saturday Weekly Refundable Bond* Price: Senior Saturday Weekly T20 Refundable Bond* Price: Processing Fee* Price: $ 0.00 Total Payment Method*PayPal Checkout MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Without this field having conditional logic for online payments the total won't factor in the fees for some reasonEmailThis field is for validation purposes and should be left unchanged.
