Please Use BLOCK CAPITALS Or TICK the APPROPRIATE BOX (All Sections to Be Completed)

We are very pleased to welcome you to Sutton-in-Craven Cricket Club. Before completeing this renewal form please read the notes below, once completed, the form along with the appropriate fee should be returned to the Membership Secretary or a club official.

Please use BLOCK CAPITALS or TICK THE APPROPRIATE BOX (All sections to be completed)

Section 1 – Membership. (2016)

A / Full (Playing) Member (£50) / (£40 if paid before 31st May 2016)
B / Social / Junior / unemployed Member (£25) / (£12.50 if paid by 31st May 2016)
(Social Member Complete sections 1,2,3,7 & 8)
C / Family Membership (£65) / Complete a form for each member)
D / Student Membership (Working / Non-Working) (£15) / If Membership fee not paid a fee of £3 will be added to the fixed match day fees.

Section 2 – Personal Details (All boxes to be completed by all applicants)

Name:
Address:
Post code / Email
Telephone / Mobile
Date of Birth / Nationality

Whilst it is not compulsory that section 2 is completed, note 2 at the end of this Membership Form explain's why this section is important.

Section 3 – Ethnicity

White / Black
Asian / Mixed
Other (please specify):

Section 4 – Medical Information

Please detail below any important medical information that the club should be aware of (e.g. epilepsy, asthma, diabetes etc.)

Section 5 – 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):

Section 6 – Emergency Contact Details

Please insert the information below to indicate the persons who should contacted in the event of an incident / accident:

Emergency Contact Person 1

Name
Relationship
Telephone / Mobile

Emergency Contact Person 2

Name
Relationship
Telephone / Mobile

Section

7 - Sporting Information

Have you played cricket before? / Yes / No
Please state where:
At what level?
Do you have any qualifications relating to the game of cricket / Yes / No
If yes please list:

Note 1

Applicants for Full (playing) Membership should complete all sections, enclose a cheque payable to Sutton Cricket Club or

cash for £50, (£40 if paid before 31 May 2016).

Applicants for Unemployed / Junior / Social membership should enclose a cheque payable to Sutton Cricket Club or cash

for £25 (£12.50 if paid before 31 May 2016).

Applicants for Memberships with, the exception of social membership, should complete all sections and return the

completed form along with the appropriate remittance to the treasurer or a club official. Applicants for Social Membership

please complete sections 1,2,3,7, & 8 and return the completed form along with the appropriate remittance to the

treasurer or a club official.

Students Membership (working and non-working) should complete all sections, enclose a cheque payable to Sutton

Cricket Club or cash for £15, if however, the £15 fee is not paid and they only play occasional games (less than 5 in a

season) then a fee of £3 per game will be added to the normal match day fee. A membership form is still required to be

completed.

Definitions

Family Membership consists of 1 Full Member, 1 Social Member and 2 Junior Members.

Junior membership for the purpose of this form is defined as a person under the age of 18 and not playing in the junior section of the club.

Students must be in full time education.

Note 2

Sport can and does play a major role in promoting inclusion of all groups in society. However, inequalities have

traditionally existed within sport, particularly in relation to gender, race and disability. Sutton-in-Craven Cricket Club

together with the England and Wales Cricket Board and Sport England are committed to promoting and developing sports

equity, which is about fairness in sport, equality of access, recognizing 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 all young

people have an opportunity in the future development and progress in sport.

Section 8 - Consent

Data Protection Consent Statement

Some of the data provided by participants is classed as sensitive data which will be used for monitoring purposes and to promote equality in coaching. We are required by law to obtain explicit consent from you before processing and storing such information. The club will not pass on this information, unless in the case of emergency to the ambulance services.

Please Tick to agree

I agree to the above Data Protection Consent Statement
I confirm that the information supplied is to the best of my belief correct
I understand in the event of injury or illness all reasonable steps will be taken to contact me/or my nominated contacts and to deal with that injury/illness appropriately. (Only required for Full Playing Member)
I agree not to bring the club or the league in to disrepute by means of publishing adverse comments or other information which may be found to be offensive on any social networking site and or any other media available to me
Name of person signing this form
Date
Signature

SR V6.0 Feb 2016

Page 1