Earby Cricket Club Junior Membership Form 2025 Season-Earby Cricket Club

Earby Cricket Club Junior Membership Form 2025 Season

ECB Safeguarding Policy The club implements an ECB Safeguarding Policy, a copy of which is available to view on our website. This application form is being used to ensure that the club is addressing all relevant areas of the policy.

Child's First Name

Child's Last Name

Child's Date Of Birth

Address

Name Of School

Previous Cricketing Experience

Yes

If Yes To Previous Experience Where Has This Been

Primary School

Secondary School

Club

County

Parents Name

Parents Address If Different to Childs Address

Parents Phone Number

Parents Email

Emergency Contact Details (Alternative Contact) - Name

Emergency Contact Details (Alternative Contact) - Address

Emergency Contact Details (Alternative Contact) - Phone Number

Emergency Contact Details (Alternative Contact) - Email

Membership Type

MEDICAL INFORMATION

Please detail below any important medical information that our coaches/junior co-ordinator need to know and which would be affected by your child’s participation in cricket activities. Such as: allergies; medical conditions (for example -epilepsy, asthma, and so on); current medication; special dietary requirements, any additional needs, and/or any injuries.

Please indicate if you would like to discuss this privately with us

Please provide details below of any important medical information

Name Of Doctor/Surgery Name

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

Not providing consent will not affect your child’s membership to the Club, however giving us consent to share this information will help club volunteers to know how to respond effectively in the case of any medical emergency.

I understand that in the event of illness/injury to my child all reasonable steps will be taken to contact me and to deal with the illness/injury appropriately

By completing this form and ticking the boxes below. I confirm that: (Please tick the appropriate boxes)

I agree to my child taking part in the activities of the club

I will supervise my child if they need to change in the club changing room

My child has to wear a helmet whilst batting or wicket keeping

We will comply with the Upper Airedale Junior Cricket League Code of Conduct

I understand the spirit of the guidelines

I understand that I will be kept informed of timing/transport details of away matches for my child

You may transport and supervise my child to away matches if they are not travelling with us

You may video & photograph my child for cricket pictures for the club/league website/local press

IMPORTANT: The data collected is for the purposes of recording & processing your membership application & to send you latest offers & news via our eNewsletter and website. All data is kept secure & it is NOT distributed to ANY third parties.

Your Signature

Date