Online Registration
NWCU Year 8-9 Training Squad
Player's Details
Name
*
DOB
*
/
Day
/
Month
Year
Date
Cricket Club
*
Parent / Guardian Details
Your Details
*
First Name
Last Name
Address
*
Address
Address Line 2
Town/City
County
Post Code
Telephone
*
Emergency Contact Number
*
Email
*
example@example.com
Medical Details
Any specific conditions or allergies requiring medical treatment, medication or special attention
*
Yes
No
If yes; please provide details for each player
Disability Information
Does your child have a disability?
*
Yes
No
If yes; please provide details
Consent
I agree to have my child photographed/videoed for publicity purposes in line with the NW/CI child protection policy.
I give permission for the coaches present to give the immediate necessary first aid & and take appropriate steps to ensure minimum delay if a medical emergency arises.
Form Completed by
*
Date
*
-
Day
-
Month
Year
Date Picker Icon
Please note to be fully insured and accepted onto this program payment must be made by 27/01/20
Payment
*
Full Program Online (£80)
Full/Deposit brought to next session
Payment Online
prev
next
( X )
Full Program
£
80.00
Total
£
0.00
loading smart payment buttons...
The payment is ready! It will be completed once you submit the form.
Submit Form
Should be Empty: