Hayes (Kent) Cricket Club
2012 Colts Membership Form
We are very pleased to welcome you to Hayes (Kent) Cricket Club. To ensure that we have the correct contact details for you, please insert the information requested below and return this form to the Club signing-on night, April 13th. If you are under 16 please also ask your parents or guardian to sign this form before it is returned.
We will also use this information to ensure that you are kept informed about club events, so up to date email addresses are essential.
Personal details
Name:
Address:
Postcode: School:
Home telephone number: Mobile:
Parents Names: Mobile(s)
Parents Email:
Date of birth: Gender: Male ¨ Female ¨
Sports equity monitoring
Whilst it is not compulsory that this section is completed the following paragraph explains why it is important.
Sport can and does play a major role in promoting the inclusion of all groups in society. However, inequalities have traditionally existed within sport, particularly in relation to gender, race and disability. Sport England is committed to promoting and developing sports equity, which is about fairness in sport, equality of access, recognising inequalities and taking steps to address them. By monitoring the profile of young people in sports clubs, national governing bodies of sport and Sport England can identify any issues relating to under-representation of different groups and can together develop strategies to ensure that all young people have the opportunity in the future to develop and progress in sport.
1. Ethnicity
In order to help the club monitor its membership can you please tick one of the following boxes to identify your ethnic group/origin:
Choose one section from A to E and then tick the appropriate box.
A White
British Irish Any other white background (please specify):
B Mixed
White & Black Caribbean White & Black African White & Asian Any other mixed background (please specify):
C Asian or Asian British
Indian Pakistani Bangladeshi Any other Asian background (please specify):
D Black or Black British
Caribbean African Any other Black background (please specify):
E Chinese or other ethnic group
Chinese Any other (please specify):
2. Disability
The Disability Discrimination Act 1995 defines a disabled person as anyone with ‘a physical or mental impairment, which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities’.
Do you consider yourself to have a disability? Yes No
If Yes, what is the nature of your disability?
Visual impairment Hearing impairment Physical disability Learning disability Multiple disability
Other(please specify):
3. Sporting information
Have you played cricket before? Yes No
If yes, where have you played the sport: (please indicate below)
Primary school Secondary school Local authority coaching session (s) Club County Other (please specify):
4. Medical information
Please detail below any important medical information that our coaches/junior coordinator should be aware of (e.g. epilepsy, asthma, diabetes, etc.)
5. Transport to Matches and Practice Sessions
Hayes (Kent) Cricket Club policy is that parents or other responsible adults are responsible for transporting players to and from all matches and practice sessions. Therefore the Club will not be registering Private Vehicles for the transportation of individuals, in connection with any fixtures or practice sessions arranged by the Club. The implementation of this policy is not intended to exclude any player from participation and parents or guardians should contact the Club Welfare Officer if they have any problems with the transportation of players to matches or practice sessions.
6. Club Changing Room Policy
For players under the age of 16 playing in adult teams the following policy applies:
Colts uncomfortable with changing or showering with adults are under no obligation to do so and are advised to change and shower at home.
Parental consent must be given if Colts are to share changing facilities with adults.
If Colts are sharing changing facilities with adults, parents have the option to supervise them whilst they are changing. The Club will make reasonable efforts to arrange this.
7. Permission for the Use of Photographs and Recorded Images
Hayes (Kent) Cricket Club recognises the need to ensure the welfare and safety of all Young People in Cricket. As part of this commitment we will not permit photographs, video images or other images of Young People to be taken or used without the consent of the Parent/Guardian and the Colt.
Hayes (Kent) Cricket Club follow the guidance issued in ‘Safe Hands – Welfare of Young People in Cricket’ on the use of images of Young People which is available at http://www.ecb.co.uk/safehands.
Hayes (Kent) Cricket Club will take steps to ensure that these images are used solely for the purpose they are intended, which is the promotion and celebration of cricketing activities.
If photographs e.g. team or action shots, are submitted to the Press or published on Hayes (Kent) CC website or in our handbook individuals will not ordinarily be identified. Where a child or young person is identified it will only be with the explicit consent of parents.
Please note: Hayes (Kent) Cricket Club understands that there are circumstances under which a parent would not wish their child to be photographed. Whilst Hayes (Kent) Cricket Club will do all that it can to ensure the safety of children during photographed events, it is the responsibility of the parent concerned to ensure that if their child is not to be photographed and partakes in an activity and is by the nature of the activity inadvertently photographed or filmed, Hayes (Kent) Cricket Club cannot be held responsible.
To be completed by the Colt (if 12 years or older) please strike out the words which you do not agree to. Parents/Guardians have the options outlined in the signature section below.
I consent / do not consent to Hayes (Kent) Cricket Club photographing or videoing my involvement in cricket under the above terms and conditions.
Signature Colt: Date:
I confirm that I have legal responsibility for this Colt and am entitled to give this consent. I also confirm that I understand and accept the Club’s policy on transportation. If this Colt participates in adult cricket he/she will change at home / he/she can change at the club / he/she can only change under supervision.
By returning this completed form, I agree to my son/daughter/child in my care taking part in the activities of the club.
I understand that I will be kept informed of these activities – for example timing and transport details.
I understand that in the event of any injury or illness all reasonable steps will be taken to contact me, and to deal with that injury/illness appropriately.
I consent / do not consent to Hayes (Kent) Cricket Club photographing or videoing my involvement in cricket under the above terms and conditions.
Signature Parent/Guardian: Date:
5. Emergency contact details (To be completed by parent/carer)
Please insert the information below to indicate the person(s) who should be contacted in case of an incident/accident:
Contact name (e.g. parent/carer)
Emergency contact number:
By returning this completed form, I agree to my son/daughter/child in my care taking part in the activities of the club.
I understand that I will be kept informed of these activities – for example timing and transport details.
I understand that in the event of any injury or illness all reasonable steps will be taken to contact me, and to deal with that injury/illness appropriately.
Name of parent/carer:
Signature of parent/carer:
Date:
Coaching commences Sunday May 6th 2011 from 10.00 – 12.00 for U9, U11 and U13 and Monday May 7th for U15, U16
Volunteers/Helpers:
We always need more volunteer helpers, coaches and team managers etc. We know that many parents would like to get involved but feel as though they may be imposing or interfering with the running of Club if they make an approach to us. Please don’t feel this way. We will welcome, with open arms, any parents/guardians who would like to help out, in any capacity. If you are interested in doing so, please indicate below. We can arrange for formal training for coaches if people are interested but would be equally keen to have helpers on an informal basis too.
Would you be willing for the Club to contact you? Yes please No thanks
Brief indication of how you may like to help ……………………………………………………………………………………………
Family Membership Fees: Boys/Girls Under 9 = £40 Boys Over 9 £80 Girls Over 9 £65 Additional Child £30
Please make cheque payable to Hayes (Kent) Cricket Club and bring along to signing on night on April 13th 2012, or send this completed form and your cheque to The Club Treasurer:- Gale Hadley, 6 Lakeswood Road, Petts Wood, Kent BR5 1BJ
Online: Sort Code 20 05 57 A/C 40454400 - Please put your child’s name in reference section!