Youth Registration Form This form should be filled in by the parent or legal guardian of any child or young person aged 17 or under. Adults should use the form Over 18s Playing/Training Application Form. Please read the information on the Codes of Conduct and Policies page. Details on this form will be held securely and will only be shared with coaches/managers/captains or others who need this information in order to meet the specific needs of your child. Your and your child's data will be retained for up to one year after your child last participated in sport at Walmley Cricket and Sports Club or until you inform us that the child has left the Club. Unfortunately for the safety and well-being of your child, we can not allow them to take part in sport at Walmley Cricket and Sports Club without the information requested in this form. Have you have filled in a Walmley Cricket and Sports Club on this site for this child/young person before, and are updating your or your child's details? yesno We will email a copy of the information you fill in (excluding the sections marked by ‡) to the email address of the person listed as the main parent/guardian/carer. Details of the Child/Young Person First Name (required): Last Name (required): Date of Birth (required) Country of Birth? (This is needed for player registrations for some leagues) MaleFemale School (required) Year Group —Please choose an option—Pre-schoolReceptionYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13 Special or Additional Needs‡ 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 Do you consider your child to have a disability, impairment or any other condition we need to know about? YesNo Please provide details Medical Information‡ Any allergies YesNo Please provide details including allergy medication Any other specific medical conditions requiring medical treatment? YesNo Please provide details including medication required (eg pain/inhaler) Details of Parents/Carers Main Contact Please fill in details of the main adult who we should contact with information about training, matches, etc. Parent/Carer's First Name (required): Last Name (required): Relationship to child/young person We need an email address and mobile phone number to contact you with details about training, matches, cancellations, etc, and in case of emergency. Please supply an email address which you check regularly Please supply a mobile number Home Address Postcode Second Parent/Guardian/Carer/Emergency Contact Please supply the details of a second adult who we can contact in an emergency if we can not contact the main contact. Parent/Carer's First Name (required) Last Name (required) Relationship to child/young person (required) Email for second parent/guardian/carer (optional) Emergency contact mobile number in case the main parent/guardian/carer is unavailable (required) Sport For the sport(s) you have signed your child up for, please indicate whether they have played before, where, and what level. Badminton Has your child played badminton before? noyes If yes, please specify where and what level Basketball Has your child played basketball before? noyes If yes, please specify where and what level Cricket Has your child played cricket before? noyes If yes, please specify where and what level Football Has your child played football before? noyes If yes, please specify where and what level Darts Has your child played darts before? noyes If yes, please specify where and what level Table Tennis Has your child played table tennis before? noyes If yes, please specify where and what level Permissions Yes, I give my consent that if an emergency medical situation arises, Walmley Cricket and Sports Club may act as loco parentis. If the need arises for administration of 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 circumstances that all reasonable steps are made. Yes, I confirm that I have read, or been made aware of, Walmley Cricket and Sports Club policies concerning: Codes for conduct for parents, Coaches, Children & Young people Transport policy Changing room policy Code of Conduct for Photography, Filming and Social Media Broadcasting I consent to Walmley Cricket and Sports Club photographing and/or videoing my child's involvement in cricket under the terms and conditions in the Code of Conduct for Photography, Filming and Social Media Broadcasting. YesNo Yes, I can confirm that my child is aware of the Walmley Cricket and Sports Club Code of Conduct for Youth Players and the Anti-Bullying Policy. Yes, I have read Walmley Cricket and Sports Club Privacy Policy and consent to Walmley Cricket and Sports Club providing my and my child's data to Walmley Cricket and Sports Club coaches, managers and others, as well as the Sport's Governing Body and Leagues etc when required in order to enable my child to take part in activities. I consent to Walmley Cricket and Sports Club providing my and my child's data to County Sport Boards for the purpose of invitations to trial for selective squads. YesNo Are you happy to be contacted about other Walmley Cricket and Sports Club events and sports? YesNo Other notes Δ Share this:TwitterFacebookWhatsApp
