Member Registration, Waiver, and Release Form

Division I Club

Player ID#:

(For office use only)

Division II Club

Have you played in the VDCA before?


Player details

Given Name (s):

Name and Birthdate must match those shown on the identification document provided below

Family Name (s):



Street Address:



Postal Code:

Email Address:

Emergency Contact Details


Alt. Phone:

Full Name:



Event: Cricket League and other competitions for 2019 (“Event”) organized by the Victoria and District Cricket Association (“VDCA”).

In consideration of the VDCA accepting me as a playing member of the Association to participate in the Event, I, for myself, my heirs, executors, administrators, and assigns, WAIVE any claims to which I may become entitled for injury or damage and HEREBY RELEASE THE VDCA and all participants in the Event, and all other organizers, executives, sponsors, representatives, agents, employees, and any other person or organization assisting in this Event, from any claims for damages or injuries suffered to me as a result of my participation in the Event including conditions of the pitch and the field, whether or not caused by negligence and/or howsoever caused including recklessness or omission of any such parties. 

I understand that there are inherent and other risks involved in the Event and injuries are a common and ordinary occurrence, and I freely assume those risks and accept full responsibility for any and all such damage or injury which may result. I am advised to wear all appropriate clothing and equipment for my protection and safety while playing in the Event and I further state that I am in proper physical condition to participate in this  event and I am aware that my participation could, in some circumstances, result in physical injury.

I understand that I am required to maintain valid Medical Services Plan coverage or similar private medical insurance to remain eligible for coverage under any insurance policy held by the VDCA. I understand that under the terms of the current policy held by the VDCA, cricket-related damage to vehicles belonging to cricketers, both players and officials, shall not be covered during the course of a game or at practices. I understand that I am required to adhere to and comply with the VDCA Code of Conduct throughout the Event. I confirm that I understand the VDCA Disciplinary Process.

I understand that this Player Registration may be rejected by the VDCA Executive Committee for any reason, including, but not exclusively, a previous or current suspension in the Province of British Columbia, or where data supplied on this form does not comply with VDCA Bylaws or Playing Conditions.

I have been recommended to obtain legal advice before accepting this WAIVER AND RELEASE.



Dated in the city of

in the Province of British Columbia, this

day of

, 2019.

Playing Member

Please check this box acknowledging you accept the terms of the agreement and this is in fact you

ID type & Ref#

Please check this box acknowledging that this information is correct.

(Name and Birthdate on ID must match info above)

Club Witness for Verification

Please check this box acknowledging that this information is correct.

Parent / Guardian

Please check this box acknowledging that this information is correct.

(Required if Member is under 19)

Parents / Guardians may not participate in the Event unless registered as Members themselves or specially accredited and invited to participate by the VDCA

All fields mandatory • Confidential when complete
Please make cheques payable to “Victoria and District Cricket Association”
Registration Player Fee is $25 per player. 

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