Student/ Concession Annual Subscription 2018

Student/ Concession Playing Membership for Shipton-under-Wychwood Cricket Club.

First Name :

Surname :

Date of Birth :

Home Telephone :

Personal Mobile :

Personal Email :

Recognised Disability :

Medical Conditions :

Cricket Committee :

I have read & agreed the Codes of Conduct :

Please sign and date below.

By doing so you are also confirming that you have read the Club Policies and Codes of Conduct

Sign & Date :

GoCardless plans:

Quantity:

+ −

My Account