Clifton Alliance CC Juniors - Signing on form 2018

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To register for the 2018 season at Clifton Alliance Cricket Club please complete this form and arrange payment. If you are new to the club, please make contact to check there is space in the age group first.
Any questions to Sid Corley on 07919344194 or caccjuniors@outlook.com

Email *

Player's First Name *

Player's Surname *

Player's middle initial

Player's Address Line 1

Player's Address Line 2

Player's Address Line 3

Player's Address Line 4

Town/City *

County

Postcode *

Parent/Legal Guardian's name *

Parent Contact Phone number *

Player's Date of Birth *

YYYY

Player's Gender

Male

Female

Clear selection

Alternative contact name (In the event of an incident or emergency situation, where a parent or legal guardian named above cannot be contacted, please provide details of an alternative adult who can be contacted by the Club. Please make this person aware that his or her details have been provided as a contact for the Club)

Alternative contact phone number

Alternative contact's relationship to the player

There is a fee to pay of £35 per player for the 2018 season. Ideally this would be paid by bank transfer when registering. If not, it should be paid by cash or cheque on the first training night. *

Bank Transfer to Clifton Alliance CC - (77-71-01 70758660)

Cash on first training night in a marked envelope

Cheque on first training night - payable to Clifton Alliance Cricket Club

Other:

Is this the player's first season at CACC? *

Yes (I have made contact with the club to confirm my place before completing this form)

No, I have attended Summer junior training at CACC before

Which School does the player attend? *

Please provide information about any impairment your child may have so that we can determine what reasonable adjustments may be required to support your child’s full participation in club activities.

Please confirm if there are any current medical conditions or history that our coaches/junior coordinator should be aware of (e.g. epilepsy, asthma, diabetes current medication, injuries etc.) *

There is no medical condition or history to be aware of

There is a condition or history to make you aware of and I will put the details in the section below

If you've answered yes above, please detail below any important medical information that our coaches/junior coordinator should be aware of (e.g. epilepsy, asthma, diabetes current medication, injuries etc.)

I give my consent that in an emergency situation the club may act in my place, (in loco parentis), if the need arises for the administration of emergency first aid and / or other medical treatment which in the opinion of a qualified medical practitioner may be necessary. I also understand that in such an occurrence all reasonable steps will be taken to contact me as the relevant parent / legal guardian, or the alternative adult I have named in this form. *

I agree

Do you have legal responsibility for the child on this form? *

I confirm that I have legal responsibility for the child named in above, and that I am entitled to give consent.

By completing this Membership Form, I agree to my child in my care taking part in the activities of Clifton Alliance CC. *

I agree

I understand that I will be kept informed of activities at Clifton Alliance CC – for example training nights, social events and times and transport details etc… *

I understand and agree

I understand in the event of injury or illness all reasonable steps will be taken to contact me / the alternative contact and to deal with that injury/illness appropriately. *

I agree

Clifton Alliance CC recognises the need to ensure the welfare and safety of all Young People in Cricket. As part of our commitment to ensure the safety of Young people we will not permit photographs, video images of Young People to be taken or used without the consent of the parental/Carers and the Young Person. Clifton Alliance CC will follow the guidance for the use of images of Young People, as detailed within the ECB Welfare of Young People Policy and will take steps to ensure these images are used solely for the purposes they are intended, which is the promotion and celebration of the activities of the cricket club.If you become aware that these images are being used inappropriately, you should inform the Club Welfare Officer (see club noticeboard for details) immediately.If at any time either the Parent/carer or the Young Person wishes the data to be removed from the website, 7 days’ notice must be given to the Club Welfare Officer after which the data will be removed. *

I consent to Clifton Alliance CC photographing or videoing under the stated rules and conditions and I confirm I have legal parental responsibility for this child and am entitled to give this consent. I also confirm that there are no restrictions related to taking photos.

I do not consent to photographing or videoing. I understand that if I do not permit my child to be photographed or videoed then it is my responsibility to ensure that this is complied with.

Please confirm you have read, understood and agree to the club's Privacy Statement on how we will use and protect your child's and your data. https://docs.google.com/document/d/1W0rsToyeRMPHNLtbBKw3Snjv21tRlsJLtBnn_NY9w_Q/edit?usp=sharing *

I have read, understood and agree

Required

I confirm that to the best of my knowledge all information provided in this form is accurate and I will inform the club of any changes to this information in a timely manner. *

I confirm and agree

A copy of your responses will be emailed to the address you provided.

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