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KCC Junior Registration 2017
Please complete this application for Junior Membership for the 2017 season.

We are a family club, not a public bar and therefore have members of all ages that we try hard to cater for. This requires a little mutual understanding and tolerance and your child’s application is therefore submitted on the basis that you accept the following;

1. We expect all members’ behaviour and language to be befitting of a family oriented sports club.

2. We hope that children enjoy coming to the club. Kids are kids but we do expect parents to ensure that they do not become unruly or excessively noisy.

3. Cricket balls can cause serious injury. Your safety and that of your family and property are wholly your responsibility while on or in the vicinity of club premises. You are asked to do what you can to ensure the safety of your own and other children. Playing members participate at their own risk

All applications must be accompanied by the appropriate subscription payment;

Current rates of subscription are: Juniors £40, Kwiks £25

Cheque's made payable to Kibworth Cricket Club, Payments may also be made using BACS using the following details, please make sure you reference your name:

Club Account details
Bank: HSBC
Sort Code: 40-32-04
Account : 91759043

Email address *
Application Form
Training When?
Sunday April 23rd - Sunday August 13th, 2017 - 09:30 - 10:30

U11 Intro to Hardball and Hardball:
Sunday April 23rd - Sunday August 13th, 2017 - 09:30 - 11:30

Friday 29th April until friday 11th August 2017 18:30 - 19:30

U15 & U17:
Thursday 13th April and throughout the season: 18:00 - 20:00

Kibworth Cricket Club, Fleckney Road, Kibworth LE8 0HG
Kwiks - £25

Juniors - £40

(all fees to be paid in full by end of May 2017)

Applicant's Details
Name *
Your answer
Date of birth *
School Year *
Parent/Guardian details *
Your answer
Address *
Your answer
Home Phone
Your answer
Mobile Phone *
Your answer
Doctor *
Your answer
Impairment or Medical Conditions (including allergies): *
Medication needed: *
(If you answer yes to either of the above please complete the supplementary medical information box below)

Please note that the completion of this registration is a prerequisite of attending coaching at Kibworth Cricket Club.
No young person will be able to take part without completing this form. The club's welfare policy is displayed on the notice board in the pavilion and a copy can be requested from the welfare office (Dan Pedley).
Do you consent to your child being photographed within the strict guidelines laid down by the ECB? *
Do you consent to information about any medical conditions your child may have being given to a responsible person (captain/coach) to ensure your child’s welfare needs are catered for? *
Do you consent that in an emergency situation the club may act in your 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? *
Supplementary medical information
Your answer
Volunteering Information
The club relies entirely on volunteers from within the membership to assist with coaching, officiating, first aid, team management, fundraising, social activities, administration, marketing, and building maintenance. Each and every member, or their parent, is kindly requested to “do their bit” to help to run the club in whatever way they can . Please state in which capacity you would be interested in helping.
Volunteering *
I authorise Kibworth Cricket Club to hold my child’s personal details electronically for purposes related to the club and its activities.

I confirm that I have legal responsibility for the child named and that I am entitled to give this consent.
I agree that both the code of conduct for members & guests and the rules for young people will be abided by, a copy of which can be obtained when handing in this form.

Please note that the contents of this form will remain confidential and information will only be disclosed to the team Coach/Managers as necessary to safeguard your child's welfare or to administer his/her cricketing activity at the club. This process is supervised by the clubs' welfare officer Dan Pedley, Tel 07841 340173, email:

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