NAME

DOB: (please complete - required for Registration purposes)

EMAIL

 (details if you would like to receive information by email)

FULL ADDRESS (inc postcode) 

TELEPHONE  - HOME

WORK

MOBILE

I WOULD LIKE TO PLAY IN THE FOLLOWING –

CHELMSFORD & DISTRICT MID WEEK               YES                               NO

SUMMER LEAGUE  - (May to July)                      YES                               NO

I NORMALLY PLAY IN THE FOLLOWING POSITIONS 

I WOULD LIKE TO TRY THE FOLLOWING POSITIONS 

I AM UNAVAILABLE ON THE FOLLOWING NIGHTS ON A REGULAR BASIS

ARE YOU INTERESTED IN PLAYING IN ONE OF THE FIRST TWO TEAMS, IF SO YOU MUST BE PREPARED TO COMMIT YOURSELF TO ATTENDING TRAINING ON A REGULAR BASIS          

 YES                                                               NO

Signed                                                                                             Date