REGISTRATION / ID NO :
DISTRICT CRICKET ASSOCIATION OF CHENGALPATTU
SOCIETY REGISTRATION NO : SRG/117/220
AFFILIATED TO THE TAMIL NADU CRICKET ASSOCIATION
NO. 5/59, VENKATESA PERUMAL FIRST STREET, NEAR VASAN EYE CARE, MADIPAKKAM, CHENNAI 600 091.
PLAYER'S REGISTRATION FORM 2023-2024
NAME OF CLUB
NAME OF THE PLAYER
1
(IN BLOCK LETTERS)
ADDRESS FOR COMMUNICATION
(ADRESS PROOF REQUIRED PHOTO
2
RATION CARD OR PASSPORT MUST
BE ATTACHED)
3 FATHER'S NAME
CONTACT NUMBERS & E-MAIL ID
(PLEASE PROVIDE ALTERNATE NOS IF ANY)
4
WHATSAPP NO
DATE OF BIRTH & AGE
(TO BE ATTESTED BY THE HEAD OF THE
5 INSTITUTION/GAZETTED OFFICER FOR NON STUDENT.
IF STUDYING SCHOOL BONAFIDE CERTIFICATE IS
REQUIRED.
PLACE OF BIRTH
6
(BIRTH CERTIFICATE TO BE ATTACHED)
NAME OF THE SCHOOL/COLLEGE
7 IN WHICH STUDYING AND THE
CLASS OF STUDYING.
WHETHER THE PLAYER HAS BEEN
REGISTERED WITH TNCA AND IF
8
YES, REGN. NO. TNCA AND THE
CLUB NAME.
BATSMAN | RH | LH | BOWLER | RH | LH | WICKET KEEPER
PROFICIENCY
OPENING BAT MEDIUM PACE YES NO
9 TOP ORDER BAT OFF SPINNER
(TICK WHICHEVER IS APPLICABLE)
MIDDLE ORDER BAT LEG SPINNER
OTHODOX
CHNAMAN
DECLARATION:
THIS IS TO DECLARE THAT MR.___________________________IS BONAFIDE RESIDENT OF WITHIN THE REVENUE DISTRICT OF
CHENGALPATTU RATIONCARD/PASSPORT COPY IS ATTACHED
PLACE:
DATE: SIGNATURE OF THE CLUB SECRETARY/PLAYER VERIFIED BY DCAC
