LRCB & ECB Affiliated

7/7 Tournament Registration Form

Section 1 – Players Details(All information provided will be held in strictest confidence by the organisation. Please be aware no player will be eligible to play without completion of this form.)

First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc
First Name(s) / Surname / Date of Birth
Address / Contact Number / Email Address
Emergency contact, name & relationship
Medical(Please detail any important medical information we should be aware of and recommended action in the event of an emergency) / E.g. asthma, epilepsy, diabetes, allergies etc

Section 2- Ithe captain of the above named team and players, have sought and do hereby give approval ofall the players listed above for participation in activities organised by Leicester Community Sports. Whilst all reasonable care will be taken by staff, I/we recognise the possibility of physical injury associated with the sport, and as part of the player being accepted, I/we hereby release, discharge and otherwise indemnify Leicester Community Sports, their members, officers, including coaches and volunteers against any claim by or on behalf of the above named players as a result of the players’ participation in the program, including all games, practices, meetings and official activities. The organisers reserve the right to suspend or expel any participants whose behaviour is considered inappropriate. Please note that photographs, video footage may be taken in order to create a photographic record and/or aid coaching techniques. Photographs may be used in future publicity. Should you not wish not to be photographed or videoed, please advise and tick this box.

Signature:______Date:______