Charley Cricket Player Application Winter 2017/18
All sections marked with * must be completed
Date of Birth
2017-18 Age Group
01/09/08 - 31/08/09 (U9)
01/09/07 - 31/08/08 (U10)
01/09/06 - 31/08/07 (U11)
01/09/05 - 31/08/06 (U12)
From September 2017
Current Cricket Club
If not a member of a Club put N/A
Parent / Guardian Name
Parent / Guardian Home Phone Number
Parent Contact Details
Mobile Phone (alternative)
Email address main contact
Email address alternative contact
Did your child participate in Charley Cricket in 2016/17
If yes, which venue did you attend
Which group was your child in?
Enter your unique reference number if known
Which Venue would you like to book
Monday - Rickmansworth School, Rickmansworth
Wednesday - Stanborough School, Welwyn Garden City
Please note that players are grouped by a mix of age and ability. You will be assigned to one of 3 groups (Muntjacs, Fallows, Sikas). We assess players regularly so you may be asked to move group during the programme. Thursday - Samuel Ryder Academy, St Albans is now full for 2017/18
Please detail any important medical information that our coaches should be aware of eg epilepsy, asthmas, diabetes, current medication, injuries
If none put N/A
Do you consider the player to have an impairment?
If yes, what is the nature of the impairment?
If other please specify
I confirm that to the best of my knowledge, my child/the child in my care does not suffer from any medical condition other than those detailed above:
I consent to the taking of photographs and films of my child and for their publication in newspapers, displays, Herts Cricket twitter and Facebook pages, Herts Cricket website reports and for coaching purposes.
I give my consent
I do not give my consent
Full details of the policy can be found on our website www.hertscricket.org
Data Protection Statement:
Hertfordshire Cricket Limited will hold the details of individuals accessing services, courses with other information it holds about individuals and will use this for the following purposes: For maintaining records / For ensuring the mandatory requirements of the ECB are satisfied / To provide and administer the goods and services you request from us. We would like to contact you by the following methods of communication: Post / email / phone with information and offers of products or services that we believe may interest you. If you do not want to receive information and offers, please indicate this on the opt out box. If you tick the opt in box you will be consenting to receive information and offers as described. You are entitled to a copy of your personal data (a small fee will be payable) and to correct any inaccuracies in it.
Please tick to complete Data Protection Statement
I do not want to receive information (opt out)
I do want to receive information (opt in)
Confirmation Email - No payment required at this time
Once you have submitted the form you will receive a confirmation email from a no reply email address. Please double check your junk mail/spam folders if you do not receive this. Once your application has been processed you will be sent a request for payment. Please note this may take upto 10 days during busy periods.