Junior Summer Registration 2024
Leamington Cricket Club Junior Summer registration form 
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Email *
Full Name of young player ( Under 18) *
Young players date of birth *
Home address including post code *
Email address(s)  of parents or legal guardians  *
Full name(s) of parents or legal guardians *
Home tel number *
Mobile tel number(s) of parents or legal guardians( please specify which is which) *
Were you registered as a member of LCC in summer 2023 *
If you registered In summer 2023 has any of your contact information( email or phone number) changed , if yes please detail any changes below . If no please answer ‘No Changes’ *
School attended *
School year group *
Which membership are you registering for *
Required
Which age group are you registering for *
One adult social membership is included with this junior membership.Please detail below the name of social member you wish to be included with this.If you wish both parents to be social members please tick social membership as well as junior above and include payment when transferring . *
In event of an emergency where a parent or guardian cannot be contacted please provide details (please include their Name ,contact number and relationship to child) of an alternative adult who can be contacted by the club.Please make this person aware that their details have been provided to the club. *
We will use this information for statistical purposes as well as to establish if there are any additional needs / support / adjustments that your child may require, please discuss this with us.The equality Act 2010 defines a disabled person as anyone with ‘a physical or mental impairment, which has a substantial and long term adverse effect on their ability to carry out day to day activities.

Do you consider this young player to have an impairment?
 *
Does this impairment or illness affect you in the following area *
Required
Has this young player played cricket before *
Has this young player played Hardball before *
If yes to above, where have they played *
Required
If answer to above is County or Club , please identify which County or Club and which age group they played in below or put N/A if not relevant *
Name , address and contact number of young players Doctor *
Please detail below any important medical information that our coaches/ junior coordinator need to be aware of such as allergies, medical conditions( eg epilepsy, asthma etc), additional needs and/ or any injuries. If none please indicate none below. If medication is required can you please ensure this is brought to training and/ or matches and detail below where this will be kept ( ie with player or supervising guardian).
Please indicate if you would like to discuss this privately with us. 
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I agree to the young player named above participating in the activities of the club *
I give consent that in an emergency situation 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, may be necessary. I also understand that in such an occurrence all reasonable steps will be taken to contact me or the alternative adult named in this form. *
For young players aged 12 and above, I agree to them participating in mixed age group cricket ( if selected for adult teams). I have read and understand the current guidelines relating to mixed age group participation( Guidelines can be found on the ECB website) *
I have read the club policies regarding the following please confirm by ticking; ( all policies can be found on the LCC website and is a condition of membership of the club that all policies are adhered to) *
Required
I understand and agree to the responsibilities which I and my child have in connection with these policies *
As parent or guardian I give consent  to the club photographing or videoing the young player named in this form in respect of their involvement in cricket in line with the clubs Video/ photography policy.If you do not wish to give consent for this please contact us to discuss how we can manage any potential photography. Not giving consent will not affect your child’s membership of the club. *
Consent of young player named in this form to the club photographing or videoing them in respect of their involvement in cricket in line with the clubs Video/ photography policy *
In respect of young players playing in open age group cricket( senior teams), many clubs now live stream matches .As parent or guardian do you consent to the young player named in this form being videoed as part of match live streaming.  *
In respect of young players playing in open age group cricket( senior teams), many clubs now live stream matches .As the young player named in this form do you consent to being videoed as part of match live streaming.  *
Leamington Cricket club is run by volunteers, as a member this is your club and as such maybe you have skills or experience that would be valuable to us.The club cannot survive without help from its members and LCC would appreciate any offers of help . Volunteers can be supported by training if required. Please indicate below any areas you would like to help *
Required
Other volunteering not detailed above
LCC relies on our generous sponsors to continue to grow the club and facilities. If you feel you may be able to offer any sponsorship please indicate below and we will contact to discuss options available.
LCC take the protection of the data that we hold about you as a member seriously and will ensure that the data you provide is processed in accordance with data protection legislation.
Please read the full privacy notice on the club website to see how the Club will treat the personal information that you have provided us.
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Please confirm membership payment has been made *
By returning this completed form, I confirm that I have legal responsibility of the young person and that I have read and understood the permission statements on this membership form and the privacy notice. Please enter full name of parent/guardian completing this form and date below
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