EmailMe Form - HERTFORDSHIRE CRICKET CLUB AFFILIATION 2024

Club Name *

Main Ground Address Details

Ground Address *

Address 2

Town *

County *

Postcode *

Clubs Main League *

If "Other" please state name of league below

Local Authority *

If "Other" then please state below

Does your Club have a functioning Defibrillator on site? *

Affiliation Category

Please select below the affiliation package for your club inline with the details provided in the Club Affiliation Package Brochure 2024

Please note PAYMENT DETAILS will be sent to you in the confirmation email which you will receive once your form has been submitted. The email will be sent to your nominated 'MAIN CONTACT EMAIL ADDRESS' which you will select in the next section. Please forward the payment information on to the relevant person at your club who can make the payment.

Please ensure all information is entered accurately below, especially email addresses.

AGM Month *

Affiliation Applying for: *

Primary Affiliation Type *

ie. main ground within the County of Hertfordshire

Associate Affiliation *

ie. play in Hertfordshire affiliated leagues and competitions but your ground/club is located outside of Hertfordshire (ie. Middx, Beds, Essex, etc.,)

Primary Affiliaton to: *

"Associate Affiliation" is only for those clubs who already primary affiliate to another County ie. Bedfordshire, Buckinghamshire, Cambridgeshire, Essex or Middlesex.

Club Officials

Please provide full details for each official and indicate which person you would like to nominate to be your MAIN CONTACT who will be included in all Club correspondence sent by HCL.

Main Club Contact *

First Last

MC Telephone Number *

11 digits no spaces

MC Email *

Club Secretary

Secretary Name *

First Last

CS Telephone Number *

11 digits no spaces

CS Email *

Club Treasurer

Treasurer Name *

First Last

CT Telephone Number *

11 digits no spaces

CT Email *

Club Chairman

Chairman Name *

First Last

CC Telephone Number *

11 digits no spaces

CC Email *

Junior Co-Ordinator

Does your club have a Junior Co-Ordinator? *

Yes

No

Junior Co-Ordinator Name *

First Last

JC Telephone Number *

11 digits no spaces

JC Email *

Women and Girls Section

Does your club have a Womens and/or Girls section? *

Yes

No

Women and Girls Contact Name *

First Last

W&G Telephone Number *

11 digits no spaces

W&G Email *

Club Safeguarding Officer

It is a condition of Affiliation for all clubs to appoint and train a Club Safeguarding Officer.

Club Safeguarding Officer Name *

First Last

CSO Telephone Number *

11 digits no spaces

CSO Email *

Does your club have an Assistant Club Safeguarding Officer?

Yes

No

Assistant Club Safeguarding Officer Name

First Last

ACSO Telephone Number

11 digits no spaces

ACSO Email

Clubmark / Safehands Contact

Does your club have a Clubmark / Safehands Management System (SHMS)
Contact? *

Yes

No

Clubmark / SHMS Contact Name *

First Last

CM Telephone Number *

11 digits no spaces

CM Email *

Payment

Payment can be made via BACs Transfer (HCCA Account details as per covering email) or via cheque payable to Hertfordshire County Cricket Association.

Amount to be paid *

Payment method *

HCL Data Protection Statement & Privacy Policy:

Hertfordshire Cricket Limited (HCL) will hold details of individuals accessing services, courses with other information it holds about individuals and will use this for the following purposes:

For maintaining records for both the County Board and Hertfordshire Accredited Leagues / for ensuring the mandatory requirements of the ECB are satisfied / to provide and administer the goods and services you request from us. We would like to contact you by the following methods of communication: post / email / phone with information and offers of products or services that we believe may interest you. If you tick the opt in box you will be consenting to receive information and offers as described. You are entitled to a copy of your personal data and to correct any inaccuracies in it.

We (the club) do want to receive information (opt in)

The Hertfordshire Cricket Limited Privacy Policy can be found on our website www.hertscricket.org