IMPORTANT STATEMENT
Player Registration and Transfer Form
In completing this form you are reminded that providing
falsification of any record or forgery of any signature is a
criminal offence. Where there is evidence of any such
falsification, forgery or use of an invalid signature or name, the
Western District Cricket Union will reserve the right to inform
the police and start criminal proceedings. Where there is any
doubt as to the authenticity of the information or signatures
provided, the Western District Cricket Union may consult with
the governing body, Cricket Scotland.
If the player is transferring from a league not subscribing to the PlayerReg registration system, this form must be scanned and
submitted as part of the player's electronic registration.
Part A to be completed by the player in all cases (the name given should be exactly as it appears in the player's passport)
Cricket Club
...............................................................................................................................................
Forename
...............................................................................................................................................
Middle Names
...............................................................................................................................................
Surname
...............................................................................................................................................
Player otherwise known as
...............................................................................................................................................
Address (line 1)
...............................................................................................................................................
Address (line 2)
...............................................................................................................................................
Town/City (line 3)
..................................................................Postcode..............................................................
Telephone
(Home)......................................................(Mobile)...............................................................
Email (optional)
...............................................................................................................................................
Date of Birth
.....................................(D)...............................................(M)............................................(Y)
Place of Birth
...........................................................(Town/City)....................................................Country
Date of entry to EU if non EU citizen
.....................................(D)...............................................(M)............................................(Y)
Nationality
...............................................................................................................................................
Part B to be completed by the player's former club if the player is transferring to the Club named above
I hereby certify that the player mentioned above has no financial, disciplinary or other obligations to the club of which I am
Secretary. If my league subscribes to the PlayerReg registration system, I confirm my club will instigate an electronic transfer on
the player's behalf to the Western District Cricket Union Club named above.
Signed
...............................................................................................................................................
Secretary
...........................................................................................................................Cricket Club
League
...............................................................................................................................................
Date
...............................................................................................................................................
I, the above named player, hereby consent to the retention and use of the above information, together with a photograph of
me, by the Western District Cricket Union for the purposes of player registration to confirm eligibility to play in cricket
competitions run by the Western District Cricket Union. I further consent to the publication of my full name, photograph * and
player registration number on the Western District Cricket Union player registration website for the same purposes only.
Player's signature
...............................................................................................................................................
Date
...............................................................................................................................................
*
N.B. No photograph will be provided or published if the player is under the age of 18 as at 31 August last season.
WDCU PRTF 2016