Dunbar Cricket Club DUNBAR CRICKET CLUB MEMBERSHIP FORM (JUNIOR)

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1 DUNBAR CRICKET CLUB MEMBERSHIP FORM (JUNIOR) Please complete this form and return to Dunbar Cricket Club with payment of (Cheque made Payable to Dunbar Cricket Club) Please contact Treasurer for details if you wish to pay by Bank transfer. Dunbar Cricket Club values the involvement of junior members in the game of Cricket. The Club is committed to ensuring that all children have fun and stay safe whilst participating in Cricket. To help the Club fulfil their responsibilities for keeping children safe Dunbar Cricket Club has introduced guidelines to tell you what you can expect from us when your child participates in Cricket and the details and information we need from you to help us keep your child safe. A membership form has to be completed at the start of every season and let us know as soon as possible if any of the information changes. All information will be treated with sensitivity, respect and will only be shared with those who need to know (Captain, First Aider, Child Protection Officer and ESCA for registration purposes). Name Junior Member of Birth: Parent / Carer Address Post Code Contact Details

2 Home Phone Number Mobile Number Address Emergency Contact Name Emergency Contact Number Please can you tick to indicate your areas of interest within the Club Playing Member Committee Role Fundraising Non Playing Member Medical Information & Consent GP Name GP Address Post Code GP- Phone Number Please Complete the Following (Answer None if not applicable)

3 Any pre-existing medical conditions that may affect your participation in Cricket: Any medication or treatment required: Any existing injuries including details of when injury was sustained and treatment: Allergies Include allergies to medication:

4 I consent to my child receiving medical treatment, including anaesthetic which the medical professionals present consider necessary. Printed Name Relationship to Child Transportation of Children to Games / Training I consent / do not consent *(Delete as Appropriate)* to my child being transported by persons representing Dunbar Cricket Club or one of its individual members of affiliated clubs for the purposes of taking part in Cricket.

5 Photographs & Publications Your child may be photographed or filmed when participating in Dunbar Cricket Club. All reasonable steps will be taken to obtain parental consent in the absence of any explicit objection. Those responsible will act in the best interests of the child which may include assuming parental agreement for the above reasons. I give / do not give *(Delete as Appropriate)* my permission for my child to be involved in photography / filming and for information about my child which could be used on Social Media (Facebook & Twitter) and on the club website. These may also appear in publicity material for Dunbar Cricket Club or local press.

6 Code of Conduct & Procedures Dunbar Cricket Club A breach of the following will be deemed serious. Dunbar Cricket Club and Coaching Staff will deal with any minor rules broken appropriately. Leaving of the sports / residential grounds without the organisers / coaches permission. Causing deliberate damage or defacing any piece of furniture or equipment. Verbally abusing any participant, coach or any facility centre staff member. Physically abusing any participant or any other person at or around the facility. Taking any form of alcohol or any illegal substances. Breaking the rules set out by the centre. Outline of procedures to be followed: Should there be a breach of any of the above the following steps will be taken to resolve the situation. Coaches / Staff meeting to discuss the incident. Parents contacted regarding their child s behavior and given opportunity to attend the meeting or have and independent representative attend. Coaches / Representatives to meet with player(s) and have independent representation or parent present in a neutral location. Coaches meet to action procedures. Participant informed of the outcome of the meeting.

7 Parent / Guardian Agreement I parent / guardian of agree to the code of conduct that is set out by Dunbar Cricket Club for their activity. I understand the procedures and the outcomes involved and I am in agreement that these procedures should be carried out. Child Agreement I agree to abide by the rules set out by Dunbar Cricket Club for their activity and I am aware that any breach of this code will incur action taken by the appropriate agencies. With regard to Social Media I agree to use this responsibly when making reference to Dunbar Cricket Club on Facebook, Twitter etc. I agree not to make any offensive or derogatory statements that could bring the club into disrepute. I also agree to abide by the constitution of Dunbar Cricket Club and the ESCA code of conduct. I will support the ethos of the Club and agree that the information given in my membership application may be held within an electronic database on behalf of the Club.