REGISTRATION FORM FOR COLT/JUNIOR CRICKET by Q9Pg4wvt

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									                                                                                        THEYDON BOIS
                                                                                        CRICKET CLUB
                                                                                                 Est. 1868

                   REGISTRATION FORM FOR COLT/JUNIOR CRICKET

SURNAME: ……………………………………………….

FIRST NAMES (IN FULL): ……………………………….

DATE OF BIRTH: …………………..

ADDRESS: …………………………………………………………………………………….

………………………………………………………………………………………………….

POST CODE: …………………………………

PARENT/GUARDIAN TEL. NUMBER                                  (HOME):              …………………………….

                                                             (MOBILE):            …………………………….

PARENT/GUARDIAN EMAIL ADDRESS:                               ………………………………………………

ALTERNATIVE EMERGENCY CONTACT
TELEPHONE / MOBILE NUMBER & CONTACT NAME

………………………………….………………………………………..

DETAILS OF ANY MEDICAL CONDITION OR ALLERGIES

…………………………………………………………………………..

I would like my child to take part in junior practice and matches organised by Theydon Bois CC. I understand that
the club and its officers, employees or agents are not under any liability whatsoever of loss of property, accidents
or injuries of or to my child howsoever caused during practice or matches played by TBCC or other grounds. I do
however understand that reasonable care will be taken to ensure my child’s safety.

The Club will use the information provided on this Membership Form (together with other information it obtains
about the player) to administer his/her cricketing activity at the Club and in any activities in which he/she
participates through the Club and to care for and supervise activities in which he/she is involved.
In some cases this may require the Club to disclose the information to County Boards, Leagues and to the England
and Wales Cricket Board. In the event of a medical issue or child protection issue arising, the Club may disclose
certain information to doctors or other medical specialists and/or to police, children’s social care, the Courts and/or
probation officers and, potentially to legal and other advisers involved in an investigation.
As the person completing this form, you must ensure that the person whose information you record on this
form knows what will happen to their information and how it may be disclosed.




SIGNATURE………….…………………(please print)……………………DATE…….…..
          (PARENT/GUARDIAN)
     Theydon Bois Cricket Club, Loughton Lane, Theydon Bois, Essex, CM16 7JY
                               WWW.TBCC.CO.UK

								
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