1. sports

SINGAPORE CRICKET CLUB MEMBERSHIP APPLICATION
FORM
Membership Department, Connaught Drive, Singapore 179681
Telephone: +65 6338 9271 Fax: +65 6337 0119
Email: [email protected] Website: www.scc.org.sg
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passport-sized
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APPLICATION FOR PARTICIPATION IN THE CLUB’S
YOUTH DEVELOPMENT PROGRAMME / JUNIOR SPORTS MEMBERSHIP SCHEME
Surname:
Title / Rank:
*Mr / Mrs / Ms / Dr / Other:
Marital Status:
Gender:
Male / Female
NRIC / Passport Number:
Date of birth (dd/mm/year):
(Please provide a copy of your NRIC / Passport)
Nationality:
Given Name:
Home Address:
Postal Code:
Telephone No.:
Mobile number:
Email Address:
If you are a full-time student (Please provide a letter from your school / institute certifying this):
Name of Institute you are attending:
Level / Course of Study:
If you are in full-time employment:
Occupation / Designation:
Company Name:
Sports Played / Years of Participation (Please attach your Sports CV)
Sports
Year(s)
School(s) / Club(s)
Other Relevant Personal / Sporting Background or Achievements (if any):
DECLARATIONS & UNDERTAKING BY APPLICANT
(Please note that an application cannot be accepted if this section is not completed and signed. If you are under 18
years of age, please arrange for your parent / legal guardian to also complete the Parental Consent section below.)
I hereby apply to participate in the Singapore Cricket Club (“SCC”) Youth Development Programme / Junior Sports
Membership Scheme. If this application is accepted, I undertake that I will participate actively in
__________________________, as my chosen sport. I will also make myself familiar with the SCC Rules and ByeLaws and other regulations as may be amended by the SCC from time to time, and I will observe them at all times.
I am also aware that, if my application is accepted, I will have to pay subscriptions and other fees, costs or
expenses related to my membership with SCC.
I confirm that all information provided in this application is true and correct. I acknowledge that any false and/or
inaccurate information provided in this application may lead to the rejection of my application. I agree to provide any
further information that is available to me and which SCC may request for in relation to my application or
membership. I also agree to notify SCC if any information I have provided becomes untrue, inaccurate or
misleading.
I confirm and agree that SCC may process and use my personal information that I provide to SCC for the purposes
of or in the manner set out in the SCC Privacy Policy, in connection with this application and/or my membership
henceforth should this application be approved.
I acknowledge that my application to join the SCC Youth Development Programme / Junior Sports Membership
Scheme will be decided entirely at the discretion of, and on the terms determed by SCC, whose decision will be
final.
Applicant’s Signature
Date:
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PARENTAL CONSENT
(If you are under 18 years of age, your parent or legal guardian must also complete this section.)
Name of Parent / Guardian*
Tel No.:
Relationship to Applicant:
Mobile No.:
Office No.:
I am the person with legal responsibility for the applicant. I confirm that I am aware of and consent to this
application. I also confirm that the information provided the applicant and myself in this application is true and
correct. I further confirm and agree that SCC may process and use the personal information of the applicant and
myself that we provide to SCC for the purposes of or in the manner set out in the SCC Privacy Policy, in connection
with this application and/or the applicant’s membership later on, if this application is approved
In the event that SCC approves this application, I hereby agree to be liable for all subscriptions, fees, costs and
expenses incurred and payable by the applicant. I also agree to indemnify and keep indemnified SCC and its
officials, employees and agents against all claims, actions, proceedings, liabilities, damages, costs and expenses
whatsoever made against or suffered or incurred by the applicant, whether caused by or arising out of or in
connection with the applicant’s participation in the SCC Youth Development Programme / Junior Sports
Membership Scheme, including, without limitation, all legal costs in relation thereto.
Signature of Parent / Guardian:
Date:
ENDORSEMENT BY SPORTS SECTION CONVENOR
(Please ensure that this section is endorsed by the relevant Sports Section Convenor prior to submitting your
application to SCC.)
Convenor’s Name:
Sports Section:
Convenor’s Signature:
Date:
FOR OFFICIAL USE ONLY
Date Received:
Mode Received:
Received By:
Receiving Staff’s Signature:
Mode of Payment:
Cheque / Cashier’s Order No.:
Remarks (if any):
Designation
Preliminary Approval:
Chairman of Games Control Board
Recommend for Membership:
Chairman of Rules & Membership Sub-Committee
Membership Approval:
President
Date Processed:
Processed By:
Application Status:
Signature / Date
APPROVED / REJECTED
Commencement Date:
Membership No. Issued:
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