Senior membership form

(for individual players aged over 18)

Mersey Rose Recreationals Cricket Club

SENIOR MEMBERSHIP FORM 2024

This form is designed to be completed by players aged over 18.

SECTION 1: PERSONAL DETAILS OF PLAYER / OFFICIAL

All information in this section will be provided to the ECB and will be used and protected as described in the Privacy Notice.
Fields marked with an asterisk are mandatory.

First Name

Last Name

Date of birth

Home Address

Postcode

E-mail

Preferred telephone number

SECTION 2: EMERGENCY CONTACT DETAILS

Name of adult who can be contacted in an emergency

Phone number of named adult

Relationship this person has with you

As the person completing the form, you must ensure that each person whose information you include here knows what will happen to their information and how it may be disclosed.

SECTION 3: SPORTING EXPERIENCE (OPTIONAL)

If "other" selected, please specify

SECTION 4: DISABILITY (OPTIONAL)

The Equality Act 2010 defines a disabled person as anyone with "a physical or mental impairment, which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities".

SECTION 5: MEDICAL INFORMATION (MANDATORY)

Please detail any important medical information that our Club volunteers may need to know, and which could be affected by your participation in cricket activities. Please state any allergies, medical conditions (e.g. asthma, epilepsy, etc.), current medication, special requirements, injuries and / or any additional needs. Please indicate if you would like to discuss this privately with us.

Medical information:

Name of GP / surgery

GP / surgery phone number

I consent to my medical information being shared with coaches / leaders for the purpose of the delivery of safe participation in cricket club activity.

Not providing consent will not affect your membership of the club; however, giving us consent willl help club volunteers to know how to respond effectively in the case of medical emergency.

SECTION 6: MEMBER AGREEMENT (MANDATORY)

I agree to taking part in Club activities.

I confirm that I have read, or have been made aware of, the club's policies conerning: changing/showering, transporting children, photography/video, anti-bullying and the code of conduct and social media/text/e-mail.

These policies are listed on the club website in the "policies and documents" section

I understand and agree to the responsibilities that I have regarding these policies.

SECTION 7: CLUB PHOTOGRAPHY / VIDEO CONSENT (OPTIONAL)

I consent to the club photographing or videoing my involvement in cricket, in line with the club' photography/video policy.

If you do not wish to give consent for this, please contact us to discuss how we can manage any potential photography or videography. Not giving consent will not affect your membership of the club.

Your name and photo may appear on the Club’s website, in match reports, on scorecards and in materials published by both the Club and the League. If you have any concerns about this and wish to speak in confidence with the Club then please contact the club at merseyroserecs@gmail.com

SECTION 8: PRIVACY STATEMENT

Mersey Rose Recreationals CC takes seriously the protection of the data that we hold about you as a member, and we will ensure that the data you provide is processed in accordance with relevant data protection legislation.

Please read the full privacy notice carefully to see how the club will treat the personal information that you provide to us, who it may be disclosed to and why, and your rights in respect to your personal data. .

SECTION 9: DIVERSITY MONITORING (OPTIONAL)

Mersey Rose Recreationals Cricket Club wants to ensure that all members applicants are treated equally whatever their race, gender, age, sexual orientation or religious belief. To do this we are asking some question about people who apply to join us. These questions are entirely optional, but we would be grateful if you would complete the following short questionnaire. Your answers will be treated in the strictest confidence and will be collated separately to the rest of the information supplied within this form.

ETHNIC ORIGIN

If "other" selected, please specify

RELIGIOUS BELIEF

If "other" selected, please specify

GENDER

If "other" selected, please specify

SEXUAL ORIENTATION

If "other" selected, please specify

Many thanks for your answers.

DECLARATION

By completing this form, I confirm that I have read and understood the permission statements on this membership form and the privacy notice.

Your Signature

Select a date

PAYMENT

Once you submit this form, you will be taken to a payment page. Select "Senior Membership" from the options and
make the appropriate payment.

Your membership is not live until payment is made.

Membership of Mersey Rose Cricket Club is open to all applicants regardless of age, ability, disability, gender, race, ethnicity, sexuality, nationality, religious belief or social/economic status.

All personal data will be kept in a secure database with access restricted to authorised club officials only.

In line with GDPR regulations, by signing and completing this application form you agree to your personal data being stored on our database. Should your membership lapse, your data will be stored for a period of one year and then deleted.