Gordon Junior Cricket Registration Form

Please fill in the form below to register your son/daughter for the Gordon Juniors in 2011/12. Please follow the instructions carefully, including the instructions for the secure online payments that we are using this season to increase our effeciency and maintain our lower costs.

* Required

Personal Details
Submitter's First Name *
Submitter's Last Name *

Player's First Name *
Player's Last Name *

Date of Birth *
Age at 31 August 2011 : Years *
Months *

Gender *

Do you have any illness / allergy / disability *
If Yes, please provide details of these.

School Before Christmas *
School After Christmas *

Please list the name of any other family members being registered with the Gordon Juniors in 2011/12.

Contact Details
Father's Name * (Enter n/a if appropriate)
Mother's Name * (Enter n/a if appropriate)

Email Address *
Secondary Email Address *

Mobile Phone Number *
Home Phone Number *
Alternate Phone Number

Home Address *
Suburb *
State *
Postcode *
Country *

Birth Certificates (New players must provide Proof of Age)
How will you provide a copy of the player's birth certificate? *	If you played at Gordon last year, please select "Played last year at Gordon." You are not required to submit a birth certificate.
Attach Birth Certificate File (100Mb Limit)

Consent Form

I agree to the Player, listed above, playing cricket with the Gordon District Cricket Club Inc. I note that the Club will undertake to exercise all reasonable care in the conduct of its activities but will not accept responsibility for accidents occuring. *

Payment Options - Secure Online Payments

Please note: Once you submit the form, you will be taken to a page within the Gordon website to pay the Gordon Junior Cricket registration fees.

There will be a 'shopping cart' where you will need to select the '2011/12 Junior Registration' ($195) and the shirts and headwear if you have indicated this on this form. If you have two or more players, please pay the registration fees all at once to receive the family discounts by adding more than one registration to the cart.

Once selected, please chose 'View Cart' then 'Check Out'. This will take you through to a secure page on our website, where you will need to re-enter the player's name and email, before chosing submit to be taken to the Paypal website for secure payment.

On the secure Paypal website you will have the option of paying by Visa or Mastercard (shown below) or a paypal account.

Paypal Credit Card Image

If you do not wish to pay by credit card (or your paypal account), please contact gordonjuniors@hotmail.com. We strongly encourage you to use this secure payment method as it reduces our administration workload and costs of the program.

Submission
Enter Word Verification in box below *

Gordon Junior Cricket Registration Form

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