SOS Booking Form

Ulverston Cricket 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 participants completes this registration form.

Please note only the first 24 applications will receive a place on this programme.

There are 16 sessions in total (see website for dates). If you are unable to attend for specific dates, please let us know so that we can try to allocate that date to someone else. Note that repeated non-attendance without informing us may result in your place on future dates being allocated to someone else. Please help us maximise participation.

Further applicants will be added to a waiting / reserve list for cancellations.

Child's Fullname
Your Email
School Year
School
Parent / Guardian 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 Summer of Sport :

I agree

I give consent to the use of photography in summer of sport actvities in respect of my child. No photographs of individual junior players will be permitted. Team photographs will not name the players.

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

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?

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 :