Membership Registration – Melbourne Cricket Coaching

Full Name of Player:*

First Name*

Age:*

Gender*

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Birth Date*

Preferred Starting Date:*

Preferred Time:*

Parent/Guardian's Full Name:*

Home Address:*

E-mail Address*

Mobile No (In Case of Emergency):*

Player's Doctor's Name:*

Doctor's Phone Number:*

Does the player have any health issues we need to know about? Any allergies or sensitivities? Any medical conditions (Eg: epilepsy, diabetes etc.) any dietary requirements?*

Anything else we need to know about your child?*

Note: The images/videos of your or your child taken by Melbourne Cricket Coaching may be used in advertising material or on MCC social media /website or for training, publicity or any other lawful business purpose by the Melbourne Cricket Coaching.

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