Name* First Last Date Of Birth* Date Format: MM slash DD slash YYYY MyCricket IDIf knownContact Number*Email* Emergency Contact* First Last Emergency Contact Phone*Emergency Contact Email* Blue Card NumberBlue Card Expiry Date Date Format: MM slash DD slash YYYY Code Of Conduct*Please read the Code of Conduct I agree to abide by the code of conduct Disclaimer*I hereby certify that the information I have provided above is true and correct. I hereby undertake and agree that I will not hold Winter Cricket and/or my Club (as indicated above) and/or any other body with which my Club is affiliated responsible for any injury or accident that I may suffer as a result of taking part in a match as a member of a team of that Club and/or Winter Cricket or attending any practice activities of that Club and/or Winter Cricket. I further undertake that I will not make any claim or take any action against Winter Cricket and/or my Club and/or anybody with which my Club is affiliated to recover any loss or expense suffered or incurred by me as a result of any such injury or accident. (Winter Cricket as a trading entity holds Public Liability & Participation Risk Insurance for its protection against any negligence that may arise due to unforeseen circumstances) I hereby certify that I have read the above undertakings and that I fully understand them and agree to be irrevocably bound by them. It is my responsibility should any of the details above change to re-complete another form immediately - until such point; please accept this registration form for all future seasons I participate in (unless advised otherwise / re-completion required by Winter Cricket): I agree Competition Rules*Please read the competition rules I agree to adhere to the competition rules Signature*EmailThis field is for validation purposes and should be left unchanged.