Membership form Membership Form Family Name First Name Gender MaleFemaleOther Date of Birth Address Zip Code/ City E-mail Address Driving License YesNo [cf7mls_step cf7mls_step-1 “Next” “”]Membership type PlayerDonorNon Playing If you have played for another cricket club, please provide the details below: Sl no. Club Team Year/Level As a member, you will be required to help out with bar & match duties. With what other duties are you willing to help the club? Youth trainerClub ScorerMaintain Website ContentTaking care of cricket materialsClub UmpireCertified CoachOrganize Social events Club membership is from January 1st till December 31st for which the membership fee is due. Membership resignations should be received before December 31st. After this date full membership fee is due. Bank Details: Account No: NL36RABO0363586350 Account Name: C.C. Qui Vive Bank: Rabobank, Uithoorn Reference: Membership Fees New members have to be introduced by two current QCC members. Please provide the following details: Sl no. Member name Signature [cf7mls_step cf7mls_step-2 “Back” “Step 2”]