Junior Cricket Membership Options 2021 :: Cove CC Junior Cricket Membership 2021 - ClubPay Memberships, Merchandise, Courses, Events: automate; improve

Age Group Squad:

Parent/Guardian Name :

Firstly, please tell us a little bit about the applicant...

First Name :

Surname :

Date of Birth :

School :

School Year :

Gender :

Ethnic Origin :

Home address :

We may need to contact you in an emergency or with important information about the club. Please carefully complete the details below...

Home Telephone :

Parent/ Guardian Mobile :

Parent/ Guardian Email :

2nd Parent/ Guardian Mobile :

2nd Parent/ Guardian Email :

2nd Parent / Guardian Name :

Emergency Contact Phone :

Please enter if different from above an emergency contact number

Emergency Contact Relationship To Child:

Now we need to be sure we have accurate and up-to-date medical information on the applicant...

Do you have any physical or mental health conditions or illness?:

Doctor's Name :

Surgery Name :

Surgery Phone :

Recognised Disability :

Medical Conditions :

PARENT: I Have Read & Accepted The Photography & Video & Social :

PARENT: Are you a member of Cove CC :

‘I consent to medical details to be shared with coaches/ leaders:

I consent to Cove Cricket Club sending me email about club infor:

I have read & agreed the Codes of Conduct :

Sign & Date :

Privacy Policy, by signing this form you accept the terms of ou :

Cove CC Junior Cricket Membership 2021