Wilcot Junior Summer Coaching Form (2017 Season)

Wilcot Junior Summer Coaching Form (2017 season)
Coaching Session Dates and Timings:

U9's - Saturdays at Wilcot Cricket Ground between 10.30 and 12.00 commencing with the first session on Saturday 29th April, and ending with the last session on Saturday 29th July.

U11's -Saturdays at Wilcot Cricket Ground between 10.30 and 12.00 commencing with the first session on Saturday 29th April, and ending with the last session on Saturday 29th July. There will be U11 matches organised throughout the season (TBC). Tuesday Nets at Wilcot Crcicket Ground between 6.00PM and 7.00PM

The sessions will be led by a team of WCC's very own qualified coaches.

U11 Head Coach - Alex Hickman - ajehickman@gmail.com

U9 Head Coach - Rod Scott-Donaldson - rod.donaldson@hotmail.co.uk
Child's Details
Full Name *

First Name Last Name
Date of Birth *

Day Month Year
School Year *
Name of School *
Has your child played cricket before?

Yes No
If 'Yes', whereabouts? (E.g. club or school name)
U9, U11 *
Medical Information
Name of Doctor / Surgery *
Doctor / Surgery Tel No *
Information About Any Impairment
Do you consider your child / the child in your care to have an impairment? *

Yes No
Please provide information about any impairment your child may have so that we can determine what reasonable adjustments may be required to support your child’s full participation in club activities.

Visual Impairment Hearing Impairment Physical Impairment Learning Difficulty Multiple Impairment Other
If you have ticked any of the options above please provide us with any additional information that will assist us to ensure your child is fully supported whilst at the club.
Medical Consent
I give my consent that in an emergency situation the club may act in my place, (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 all reasonable steps will be taken to contact me as the relevant parent / legal guardian, or the alternative adult I have named above.
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 agree with the two statements above *

Yes No
Parental Contact Information
Parent / Carer's Name *

First Name Last Name
Home Tel No *
Mobile Tel 1 *
Mobile Tel 2
Email 1 *
Email 2
Home Address *
Alternative Emergency Contact Information
Alternative Carer's Name

First Name Last Name
Relationship to Child
Home Tel
Mobile Tel
Net Programme Booking And Payment
Form Completion & Payment Notes

To confirm your child's attendance please complete this form and press submit at the bottom of the page. Please bring a cheque payable to Wilcot Cricket Club or Cash on the registration day or the first session that your Child can attend.

The relevant subscription for these training and net sessions 'Full Junior Subs 2017', and the cost is £40.
Amount Paid *
Additional Information or Comments
Submit Form
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Wilcot Junior Summer Coaching Form (2017 season)

Child's Details

Medical Information

Information About Any Impairment

Medical Consent

Parental Contact Information

Alternative Emergency Contact Information

Net Programme Booking And Payment

Submit Form