Youth Registration & Parental / Guardian Consent
This form is also to be used when taking young people on away fixtures.Worlington Cricket Club (WCC) will use one form per season for all away fixtures. The Home Contact will be provided with a fixture card and contact details of all Club Officials. The Home Contact will be advised of the club contact, prior to each away game.

Player: To ensure we have the correct contact details for each player, please insert the information requested below. Please note that separate entries will be required if registering more than one youth player at a time.

Junior membership is £40 for the season.

Sign in to Google to save your progress. Learn more
Email *
Player Name *
Date of Birth *
MM
/
DD
/
YYYY
School Year
Home address *
Parent / Guardian / Emergency Contact Name *
Mobile number *
Work number
Email address *
Doctor's name and contact number *
What can / are you willing to help with on training nights ? Must select at least 1 *
Required
What can / are you willing to help with on match days ? Must select at least 1
What others skills do you have that may benefit the club or what support can you offer to help the club ? *
Required
Other skills / help you think may benefit the club please list below. *
If you are interested in becoming a coach or coach helper please speak to a coach about possible courses, or if you want to enhance current level of qualification then please let a coach know.
I am aware of the ECB Welfare of Young People guidelines in relation to away fixtures. (A copy of the safe hands policy is available to view at the clubhouse or on the internet at www.ecb.co.uk/ecb/safeguarding-children-and-child-protection )I consent to my child taking part in the activities of the club. I acknowledge that the club will be liable in the event of any accident only if they have failed to take reasonable steps in their duty of care for my child during the session.I agree to be at the pick-up/drop off point at the agreed time.I agree to my son/daughter travelling to away fixtures.I understand and accept all rules & regulations set out by Worlington Cricket Club and agree to pay the subscriptions which cover player insurance. - (All youth players need to be fully paid up members of W.C.C. to be covered by the clubs insurance when playing).I have received a copy of the club’s code of conduct and will adhere to it.I understand that if at any times I have any problems or complaints then I will let the club know in writing as soon as possible. Any complaints should go to the Child Welfare Officer. *
Required
Where possible U16 children will not change at the same time as adults. However, there may be occasions when this is not possible. I agree to my child sharing changing facilities with adults. Should I wish, I know I am able to supervise their changing (N.B. This relates to adult fixtures)
During the season the club will take photographs of teams & players in action. Video recorders may also be used for coaching purposes. Photographs may  be used to publicise activities at the club. Your consent is requested to allow us to continue with these practices.
Medical Information
Does your child experience any conditions requiring medical treatment or medication? *
Required
If yes, please give details
Does your child have any allergies?
If yes, please give details
Does your child have any specific dietary requirements?
If yes, please give details
Does your child have any disabilities?
If yes, please give details
Please provide any further information you feel is necessary
Signed (Please print name) *
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms