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.

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

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

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 and I have read, understand and will comply with the Club's Code of Conduct.

I Agree*

I also give consent to the use of photography in the coaching of cricket in respect of my child.

I Agree*

I accept the club’s policy for junior changing rooms

I Agree*

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 and all reasonable steps will be taken to contact me.

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

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