Junior membership form

(for all players under the age of 18)

This form is designed to be completed by the parent or legal guardian of players aged 18 or under. Those aged 16-18 and playing senior cricket should complete the senior membership form and pay the appropriate annual membership fee

SECTION 1: PERSONAL DETAILS OF YOUNG PLAYER(S)

Young person 1

First Name

Last Name

Date of birth

Home Address

Postcode

Young person 2 (if applicable)

First Name

Last Name

Date of birth

Young person 3 (if applicable)

First Name

Last Name

Date of birth

SECTION 2: PERSONAL DETAILS FOR PARENT / LEGAL GUARDIAN

First Name

Home Address (if different)

Last Name

Postcode (if different)

E-mail

Preferred phone number

SECTION 3: EMERGENCY CONTACT DETAILS

First Name

If not, please provide the contact information for an alternative adult below

Name of emergency contact

Phone number

Relationship this person has to the child (e.g. aunt, neighbour, grandparent, etc.)

As the person completing the form, you must ensure that each person whose information you include here knows what will happen to their information and how it may be disclosed.

SECTION 4: SPORTING EXPERIENCE (OPTIONAL)

SECTION 5: DISABILITY (OPTIONAL)

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".

SECTION 6: MEDICAL INFORMATION (MANDATORY)

Please detail any important medical information that our coaches / junior co-ordinator may need to know, and which could be affected by your child's participation in cricket activities. Please state any allergies, medical conditions (e.g. asthma, epilepsy, etc.), current medication, special requirements, injuries and / or any additional needs. Please indicate if you would like to discuss this privately with us.

Medical information:

Name of GP / surgery

GP / surgery phone number

I consent to my child's medical information being shared with coaches / leaders for the purpose of the delivery of safe participation in cricket club activity.

Not providing consent will not affect your child's membership of the club; however, giving us consent willl help club volunteers to know how to respond effectively in the case of medical emergency.

SECTION 7: PARENT / GUARDIAN PARTICIPATION AGREEMENT (MANDATORY)

I agree to the child named above taking part in club activities.

I confirm that I have read, or have been made aware of, the club's policies conerning: changing/showering, missing children, transporting children, playing in open age (senior) matches, photography/video, anti-bullying and the code of conduct, sun guidance and social media/text/e-mail.

These policies are listed on the club website in the "policies and documents" section

I understand and agree to the responsibilities that I and my child have regarding these policies.

I confirm I have been given comprehensive details of the home and away fixtures in which my child may participate.

SECTION 8: CLUB PHOTOGRAPHY / VIDEO CONSENT (OPTIONAL)

I consent to the club photographing or videoing my child's involvement in cricket, in line with the club' photography/video policy.

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

SECTION 9: PRIVACY STATEMENT

Rainhill CC takes seriously the protection of the data that we hold about you as a member, and we will ensure that the data you provide is processed in accordance with relevant data protection legislation.

Please read the full privacy notice carefully to see how the club will treat the personal information that you provide to us.

PARENT / GUARDIAN AGREEMENT

By completing this form, I confirm that I have legal responsibility for the child named above. I also confirm that I have read and understood the permission statements on this membership form and the privacy notice.

Signature of parent / guardian

Select a date

Many thanks for submitting the membership form!