Return to Mrs. L. Robertson, 1, Rose Villas, Jackson’s Lane, Reed, Royston, Herts. SG8 8AB
—————————————————- POST CODE: ——————————–
DATE OF BIRTH: —- /—- / —— AGE ON 01/ 09 / 2017 ——YEARS.
HOME TELEPHONE NO. ——- / ————-
EMERGENCY CONTACT NO(S). ——/——————-
EMAIL —————————- @ ————————-
ANY DETAILS OF HEALTH: ( Asthma? Epilepsy? Allergies?)
CONTINUOUS MEDICATION: (Inhalers? anti-histamine?)
To be signed by Parent / Guardian.
I have read the information sheet and accept the terms of membership for Reed Cricket Club Colts.
I have been DBS checked by the ECB. □
Disclosure No. ————————————— Date of Issue: —————————
Data protection. The club will use the information provided on this form, as well as, other information it obtains about the player to administer his/her cricketing activity at the club, and in any activities in which he/she participates through the club, and to care for, and supervise, activities in which he/she is involved. In some cases, this may require the club to disclose the information to County Boards, leagues and to the ECB. In the event of a medical or child safeguarding issue arising, the club may disclose certain information to doctors or other medical specialists and/or to police, children’s social care, the courts and/or probation officers and, potentially, to legal and other advisers involved in an investigation. As the person completing this form, you must ensure each person whose information you include in this form knows what will happen to their information and how it may be disclosed.
PARENT / GUARDIAN: DATE: —- / — / 2018
*I enclose £50.00p cash / cheque * (payable REED CRICKET CLUB ) * Please delete as applicable