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Firstly, please tell us a little bit about your cricketing child…
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Please provide the full name of the applicant
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Please provide the applicant's date of birth
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Please provide the name of the school attended by the applicant
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Please tell us the age group to which the applicant belongs - age as at 31/08/2025
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Please provide details of any recognised disability(ies), diagnosis or medical conditions that their coach should be aware of
If none, please enter N/ A
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Please ONLY choose 'Additional Sibling Membership' if you have already completed and paid for a membership form for another child from the same family. Note that incorrectly selecting Additional Sibling Membership will void the membership.
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In order to support the ECB’s monitoring of diversity and inclusivity in cricket we would like to ask the following questions
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Next, please tell us how to get in touch with the applicant and their parent/ carer...
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Please provide the name of the applicant's parent or carer
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Please provide the applicant's home phone number
Please note that you should provide both area code and telephone number, separated by a space
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Please provide the mobile phone number of the applicant's parent or carer
Please note that you should provide both code and telephone number, separated by a space
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Please provide the email address of the applicant's parent or carer; please note, that this should be an email address in regular use as this this is the address to which we will send important emails from the club
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We may need to contact you or another responsible adult in an emergency; we may also need to seek medical assistance, so please CAREFULLY complete the details below...
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Please provide the Name & Relationship (e.g. Other Parent/Carer, Guardian, Family Friend, Other Relative, etc) of someone who can be contacted in the unlikely event of an Emergency and if the main parent or carer is unavailable
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Please provide the Landline or Mobile Telephone Number of an Emergency Contact
IMPORTANT: this should be a number on which we can almost certainly reach them in the unlikely event of an emergency
Please note that you should provide both area code and telephone number, separated by a space
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The next few questions apply to the parent/ carer of the applicant...
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As parent/carer for the applicant, I have no objection to their being photographed or video recorded when playing, as authorised by their Coach
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In the event of an emergency, and if a parent or guardian is not contactable, W&S CCJ is authorised to decide on an appropriate course of action for my child. Parents/Guardians are responsible for providing equipment applicable to any medical conditions
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PARENT: Opt in to Associate Membership
Parent of the applicant, please tick this box if you wish to become an associate member of the club, free of charge.
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Please enter the names of any associate members you wish to add.
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Almost finished, just the formalities to complete...
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Club Communication Opt-in
We would like to send you the occasional email related to cricketing news and club activities. Please opt in if you would like to receive these
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I have read & agreed the T&Cs *
Please tick this box to confirm that you / the applicant have read and agreed to the relevant and applicable Terms & Conditions, Codes of Conduct and Rules
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I understand this is a legal representation of my signature.
Clear
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