If you/your child has a disability, please provide details: *
Your answer
Please provide details of any important medical information: (e.g: Asthma, Epilepsy, Allergies etc) *
Your answer
Doctors Surgery: *
Your answer
Surgery Address: *
Your answer
Surgery Telephone Number: *
Your answer
LEGAL AUTHORITY TO PROVIDE CONSENT 2023 SEASON
Please tick those that apply
I confirm that I have legal responsibility for the above named child and I am entitled to give this consent. I confirm that, to the best of my knowledge, all information provided on this form is accurate and I will undertake to advise the club/coach of any changes to this information.
MEDICAL CONSENT: I give my consent that in an emergency, the club may act in my place (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, maybe necessary. I also understand that in such an event, all reasonable steps will be taken to contact me or the emergency contact which I have named above on this form. *
CONSENT TO PARTICIPATE: *
I agree
I do not agree
Not Applicable
I agree to the person named above taking part in the activities of the club
I confirm that I have read or been made aware of the club's Safeguarding Children Policy Statement (Available to view on Spond)
I understand and agree to the responsibilities which I and the child have in connection with these policies.
I consent to being contact via Spond, email, telephone, text or social media on the details given above
I confirm that I will respect the coaches' decisions on team selections and training.
I consent to the club photographing or filming the above named child's involvement in the cricket under the terms and conditions of the club photography/video policy.
I agree to pay the annual £15 registration fee & weekly training costs via Spond or cash
I agree
I do not agree
Not Applicable
I agree to the person named above taking part in the activities of the club
I confirm that I have read or been made aware of the club's Safeguarding Children Policy Statement (Available to view on Spond)
I understand and agree to the responsibilities which I and the child have in connection with these policies.
I consent to being contact via Spond, email, telephone, text or social media on the details given above
I confirm that I will respect the coaches' decisions on team selections and training.
I consent to the club photographing or filming the above named child's involvement in the cricket under the terms and conditions of the club photography/video policy.
I agree to pay the annual £15 registration fee & weekly training costs via Spond or cash
Signature of Participant or Parent/Legal Guardian if U18: *
Your answer
Printed Full Name: *
Your answer
Date: *
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Norwich Cricket Club is run purely on volunteers, from time to time we need help with works in the clubhouse, if you are willing to help out or have a trade that could help us, then please complete the box below. Many thanks from all at NCC.