Junior Registration


Junior Details

Do you already have a MyCricket profile?
YesNo

MyCricket Number

Previous Clubs

A MyCricket profile will be created for all those new to cricket.
Please ensure you update all of your details.

First Name*

Middle Name/Initial

Last Name*

Date of Birth*


Parent/Guardian Details

Name

Mobile

Home Phone

Work Phone

Email

Address

Suburb

State

Postcode*


Additional Details

Does the participant have any illness or allergy for which medication is required?
YesNo

If yes, please provide details

Does the participant have a physical, intellectual or sensory impairment?
YesNo

Is there anything that can be done to assist participation?

Is the participant of Aboriginal or Torres Strait Islander descent?
YesNo

Is the participant from a culturally or linguistically diverse background?
YesNo


Do you have any of the following certifications?


Level:


ID Number:


Level:


Date of Issue:


Level & Date of Issue:

We're looking for sponsors to help the club, do you know of anyone that might be interested in sponsorship opportunities?

We require all applicants to undergo background checks and screening prior to or during any appointment. Australian Cricket’s Commitment Statement to Safeguarding Children and Young People can be found at https://thepanthers.com.au/juniors/australian-cricket-safeguarding-children-and-young-people/.

By ticking this box, I agree to be bound by any Codes of Behaviour and policies of North Balwyn Combined Cricket Club for the time being in force, including Australian Cricket’s ‘Looking After Our Kids’ Code of Behaviour for Affiliated Associations and Clubs.
I agree

Sponsors