Junior Membership 2018

We are very pleased to welcome you to Petworth Park Cricket Club. To ensure we have the correct contact details for you please complete this membership form online and our Membership Secretary will be in touch to collect payment.

If you'd prefer to receive a membership form by post, please contact us at membership@petworthparkcricket.org

Section 1: Personal Details
Child's Name *
Child's Name
Child's Date of Birth *
Child's Date of Birth
Gender *
Home Address *
Home Address
Name of Parent/Guardian *
Name of Parent/Guardian
Section 2: Membership & Fees
Payment Method *
Junior Membership for 2018 is £40, including all weekly Junior Cricket Sessions throughout May, June, July & August. How would you like to make payment?
Family Membership
Would you like this Membership to be part of a Family Membership? If you tick yes, we will look out for your other membership forms and link them together and apply the household cap of £100.
Section 3: Playing Profile
Section 3: Please tell us about your child's cricket playing experience and background.
How many years has your child been playing cricket? *
Where has your child previously played cricket? *
Section 4: Medical & Consent
The Club has adopted the ECB's 'Safe Hands' Welfare of Young People in Cricket Policy, please therefore complete the following information and consents options.
Any known allergies or medical conditions (e.g. epilepsy, asthma, diabetes - medication must be provided):
Medical Consent *
I give my consent that in an emergency situation, the Club 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 occurrence that all reasonable steps will be taken to contact me or the alternative adult/s whom I have named as emergency contacts on this form.
Confirmation *
Section 5: Emergency Contact Details
Emergency Contact 1: *
Emergency Contact 1:
Emergency Contact 2:
Emergency Contact 2:
Section 6: Declaration
Photographic Consent
We would like to be able to promote cricket in Petworth Park by using images of cricket being played. By clicking 'I consent' below, you give consent for your child / yourself to be photographed / videoed during Club activities and name used on the Club website or social media channels to promote the Club.
Confirmation *
Data Protection: The information you provide in this form will be used solely for dealing with you as a member of Petworth Park Cricket Club. Your data will be stored and used in accordance with the Club's Data Privacy Policy. I confirm I have read, or been made aware of, the Club’s Constitution, Code of Conduct, Data Privacy Policy and policies including those concerning the welfare of young people in cricket (copies available on website, at club and from welfare officer). I give my consent to be kept informed of Petworth Park Cricket Club's news and events. I understand that any photos or videos that I take of my child during the junior cricket sessions may not be used on social media or in the public domain.