Dorset CRICKET BOARD

Player Profile Form

Data Protection

The management will use the information provided on this form (together with other information it obtains about the player - together “information”) to administer his/her cricketing activity in Dorset and in any activities in which he/she shall participate in as a result of this involvement. The information will also be used to care for and supervise activities in which he/she is involved. In some cases we may be required to disclose this information to the Dorset Cricket Board (DCB) and the England and Wales Cricket Board (ECB). In the event of a medical issue or child protection issue arising, we 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 that each person whose information you include in this form knows what will happen to their information and how it may be disclosed.

Personal Details for young player and their Parent/legal Guardian:

Name of Child (under 18) / Child’s Date of Birth / Name of Parent/legal guardian
Home Address / Postcode / Email Address
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Home Telephone Number / Work Telephone Number for parent/legal guardian / Mobile Telephone Number for parent/legal guardian

Emergency Contact Details

In the event of an incident or emergency situation, where a parent/legal guardian named above cannot be contacted, please provide details of an alternative adult who we can contact. Please make this person aware that his/her details have been provided as a contact to us.

Name of Adult / Phone Number / Relationship to the child

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/her ability to carry out normal day-to-day activities’.

Do you consider this child to have a disability?YesNo

If yes, what is the nature of their disability?

Medical Information

Please detail below any important medical information that our Coaches need to know (e.g. allergies, medical conditions, current medication, special dietary requirements, injuries)
Name of Doctor/Surgery Name
Doctor’s Telephone Number

Consent Statement from Parent/Legal Guardian

Please tick each box where you agree (or leave blank if you do not agree)

Legal Authority to provide consent;

I confirm that I have legal responsibility for (name of child) and am entitled to give this consent.

I confirm that to the best of my knowledge, all information provided on this form is accurate, and that I will undertake to advise the county management of any changes to this information.

Consent to Participate;

I agree to the child named above taking part in any activities associated with the County squad.

Medical Consent;

I give my consent that in an emergency situation, the County manager or coach may act in 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 that all reasonable steps will be taken to contact me or the alternative adult whom I have named in this form.

I confirm that to the best of my knowledge, my child does not suffer from any medical condition other than those detailed by me in this form.

Video and Photography;

I consent to the Club photographing or videoing my child’s involvement in cricket under the terms and conditions in the County photography / video policy. [NOTE: THIS BOX SHOULD BE LEFT UNTICKED IF YOU DO NOT AGREE]

Player Agreement

The player will agree and abide by the following code of behaviour.

  • Treat everyone equally and not discriminate on any grounds.
  • The spirit and laws of cricket shall be followed at all times during matches and any actions of dissent or disrespect towards umpires, opponents, captains, team-mates and officials will not be tolerated.
  • Success and failure must be handled in a correct and mature manner.
  • The decision of the coach must be respected at all times.
  • In case of any unexpected sickness, injury or availability over the duration of the training programme and the season, the coach must be informed promptly.
  • Players are expected to be appropriately dressed for the situation and use clean and acceptable equipment (Wearing of helmet and box is mandatory).
  • No jewellery to be worn.
  • Players are expected to arrive at sessions and matches for the appointed time, ensuring they are ready to start the session promptly.
  • Players are expected to advise the coach of any injury problems as soon as they occur. Playing when not fully fit can seriously hinder the team, as well as potentially leading to more serious injury.
  • Players shall not partake of alcohol, tobacco or drugs at any time.
  • Players will refrain from swearing.
  • Players must ensure that they do not over train or overplay. Bowlers must keep a record and inform the coach of how many over’s they are bowling per week; this will ensure that the bowling regulations are adhered to.
  • The Manager may restrict the use of mobile phones by players, as deemed appropriate.
  • Always give 100% effort to all situations; be it in the face of victory or defeat.

If any player breaks this code then non-selection could result depending on the seriousness of the incident.Parents are expected to support the implementation of the code of conduct and promote the spirit of the game at all times. In the event of any concerns the coach must be consulted.

Print Name:Sign & Date:

Parent/Legal Guardian Agreement

The Parents / Guardians agree to:

  • Encourage the player to adhere to the code of conduct and other rules and regulations of the Dorset Cricket Board.
  • Support the player without undue pressure, offering praise and encouragement for good work and effort.
  • Refrain from criticising or interfering in the work of the county staff.
  • Avoid coaching the player as you have entrusted the development of the player to the county staff.
  • Communicate with the Coach and Manager with regard to any matters which affect the player.
  • Set a good example at all times to give the player the best opportunity to succeed.

Print Name:Sign & Date:

Print Name:Sign & Date:

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