Junior Membership Form

The club has adopted the ECB Child Welfare, Protection and Safeguarding Policies. It is a requirement of these policies that the parent or guardian of all young players completes this registration form.

Child's Full Name*
Date of Birth *
School Year*
Parent/Guardian Name*
Street*
Town*
Post Code*
Email Address*
Home Telephone*
Mobile*
Emergency Contact Name*
Emergency Contact Telephone*

Please complete and sign this form, and signify your acceptance of the statements below by ticking the boxes

I agree to my son/daughter/child in my care, taking part in the activities of the club.

I Agree*

I confirm that my child will comply with the Junior Code of Conduct.

I Agree*

I confirm that I understand and will adhere to the Parents’ Code of Conduct.

I Agree*

I also give consent to the use of photography in the coaching of cricket in respect of my child. No photographs of individual junior players will be permitted. Team photographs of junior teams will not name the players. Photographs of adult teams that may contain a junior player will not indicate that the player is a junior.

I Agree*

I understand that I will be kept informed of cricket activities at the club, for example timing and transport details for away matches when my child is involved. The assistance of parents to transport junior players to away matches will be greatly appreciated. Where this is not available team coaches will endeavour to obtain the assistance of senior players or club officials to provide transport. No player or other person assisting with transport will travel alone with only one child in the car.

I Agree*

I accept the club’s policy for junior changing rooms

I Agree*

I understand that in the event of any injury or illness, all reasonable steps will be taken to contact me and to deal with that injury/illness appropriately.

I Agree*

I consent to my child playing in matches with adult cricketers on the understanding that the ECB policy in respect of protective equipment and fielding positions will be strictly adhered to.

I Agree*

 

It is a requirement of the club’s child welfare policy that we record information on disability, and we would therefore be grateful if you could complete the next section :

DISABILITY

The Disability Discrimination Act 1995 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 your child have a disability?

Yes No*

If yes, what is the nature of the disability?

Visual impairment
Hearing impairment
Physical disability
Learning disability
Multiple disability
Other (please specify)

 

MEDICAL INFORMATION

1. Does your child experience any conditions requiring medical treatment and/or medication?

Yes No*

If yes, please give details

2. Does your child have any allergies?

Yes No*

If yes, please give details

3. Does your child have any specific dietary requirements?

Yes No*

If yes, please give details

4. Please provide any further information you feel is necessary

  • I confirm to the best of my knowledge that my son/daughter does not suffer from any medical condition other than those detailed above.
  • I consent to my child receiving medical treatment which, in the opinion of a qualified medical practitioner, may be necessary

Print Full Name : *

Date :

Ulverston Cricket Club take the protection of the data we hold about you as a member seriously and are committed to respecting your privacy. This notice is to explain how we may use personal information we collect and how we comply with the law on data protection, what your rights are.

Our full data privacy can be viewed here :

Data Privacy Notice