U18 Registration Form

U18 Membership

This form is designed to be completed by the parent, or legal guardian of any player under the age of 18.

Please refer to the Policies section to find policies that are mentioned in this form. All fixtures can also be found via the Fixtures button.

Section 1 Personal details for young player and their parent/legal guardian *

Name of child (under 18):

School year *

Child’s date of birth: *

Names of parent or legal guardian *

Home address *

Address Line 2

Town *

County *

Postcode *

Email address for parent/guardian: *

Mobile telephone number for parent/guardian:

Section 2 Emergency contact details: In the event of an incident, or emergency situation, where a parent or legal guardian named above cannot be contacted, please provide details of an alternative adult who can be contacted by the club. Please make this person aware that his/her details have been provided as a contact for the club:

Name of an alternative adult who can be contacted in an emergency:

Phone number for alternative named adult:

Relationship which this person has to the child (for example, aunt, neighbour, family friend and so on)

Section 3 Disability: The Equality Act 2010 defines a disabled person as anyone with ‘a physical or mental impairment, which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities’.

Does the child have any physical or mental health conditions or illnesses that have lasted or are expected to last 12 months or more?

Does this disability or illness affect the child in any of the following areas?

Visual impairment

Hearing impairment

Physical disability

Learning disability

Multiple disability

Other (please specify)

Section 4 Sporting information

Has this child played cricket before?

If yes, where has this been played?

Checkboxes

Primary school
Special educational needs school
Club
Secondary school
County
Other (please specify):

Other… please specify below:

Section 5 Medical information: Please detail below, any important medical information that our coaches/junior co-ordinator need to know. Such as: allergies; medical conditions (for example - epilepsy, asthma, and so on); current medication; special dietary requirements, any additional needs, and/or any injuries. *Please indicate if you would like to discuss this privately with us.

Name of doctor/surgery name *

Doctor’s telephone number *

Consent statement from parent/legal guardian Please tick each box where you agree (or delete if you do not agree) Legal authority to provide consent: I confirm I have legal responsibility for (name of child): *

Type name of child in field above.

and am entitled to give this consent. I confirm to the best of my knowledge, all information provided on this form is accurate, and I will undertake to advise the club of any changes to this information

I confirm information is correct

Medical consent: I give my consent that in an emergency situation, the club may act in my place (loco parentis), if the need arises for the administration of emergency first aid and/or other medical treatment which, in the opinion of a qualified medical practitioner, may be necessary. I also understand that in such an occurrence all reasonable steps will be taken to contact me or the alternative adult which I have named in section two of this form.

I give medical consent

I confirm to the best of my knowledge, my child/the child in my care does not suffer from any medical condition other than those detailed by me in section five of this form. ***I agree that an adult will be present throughout training sessions and will ensure that my child will be registered before joining the session each week. Signed (parent/legal guardian):

By checking this box it is the same as a signature

Section 6: Parent/carer/legal guardian participation agreement. I agree to the child named above taking part in the activities of the club: *

I confirm I have read, or have been made aware of, the below Club’s policies - see below: *

• Anti-Bullying
• Changing Rooms and Showering Facilities
• Club Safeguarding Policy Statement
• Code of Conduct
• Creating a Safe, Welcoming and Inclusive Environment
• Junior Players Playing in Open Age Cricket
• Managing Children Away from the Club
• Photo, Video and Live Streaming
• Responding to, Recording, and Reporting Concerns
• Social Media
• Transport to and from Matches and Training

I understand and agree to the responsibilities which I and the child have regarding these policies: *

I consent to the club photographing or videoing the above-named child’s involvement in cricket in line with the Club Photo, Video and Live Streaming policy: *

If you do not wish to give consent for this, please contact us to discuss how we can manage any potential photography. Not giving consent will not affect the child’s membership of the club.

Section 7: Privacy Statement *

The club take the protection of the data we hold about you seriously and will ensure the data you provide is processed in accordance with data protection legislation. Please carefully read the full privacy notice below to see how the club will treat the personal information you provide to us. I confirm I have legal responsibility of the above-named child and that I have read and understood the permission statements on this membership form and the privacy notice below.

PRIVACY NOTICE: Under data protection law, we need to provide you with certain details concerning how your personal data and that of the child will be used and protected. Please see full Privacy Policy.

Date of signing *

Printed name of parent/legal guardian who has completed this form *

Every Friday evening from mid-April Youth training is on the Green.

Matches are played regularly on a Saturday & Sunday through late Spring, Summer and early Autumn.

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