In the event of an incident or emergency situation, where a parent or legal guardian named above cannot be contacted, please provide details of an alternative adult who can be contacted by the club. Please make this person aware that his or her details have been provided as a contact for the club:

Please detail below any important medical information that our coaches need to know (e.g allergies, medical conditions, current medication, special dietary requirements, injuries, etc)

The club will use the information provided on this form (together with other information it obtains about the player) to administer his/her cricketing activity at the club any in any activities in which he/she participates through the club and to care for and supervise activities in which he/she is involved. In some cases this may require the club to disclose the Information to County Boards, Leagues and to the England and Wales Cricket Board. In the event of a medical issue or child protection issue arising, the club may disclose certain information to doctors or other medical specialists and/or to police, children’s social care, the courts and/or probation officers to legal and other advisers involved in an investigation. As the person completing this form you must ensure that each person whose information you include in this form knows what will happen to their information and how it maybe disclosed.