For Colts, please enter your current school

Please enter a second contact. This would only be used in an emergency (Name and phone number)

Please state the nature of the impairment.

Name of doctor/Surgery & telephone number

In an emergency situation the club may act in my place (in loco parentis), if the need arises for the administration of first aid and /or 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 the emergency contact as named in this form.

Please note Copford CC understands that there are circumstances under which a parent would not wish their child to be photographed. Whilst Copford CC will do all that it can to ensure the safety of children during photographed events it is the responsibility of the parent concerned to ensure that their child is not to be photographed and partakes in an activity and is by the nature of the activity inadvertently photographed or filmed Copford CC cannot be held responsible.

Copford CC may use images taken for publications or event articles.

Copford CC would like to communicate with you as a member of the Club via Team App, either by Email or Push Notifications onto your smart Phone.