Colt Enrollment Form

To qualify as a Colt member of the club you must be 17 or younger on the 31st August of the year in which the enrolled season begins. If you are 18 or older on the 31st August of the year in which the enrolled season begins, you must enroll as an Adult member of the club.

This form MUST be completed by the PARENT or LEGAL GUARDIAN of the Colt.

The PARENT or LEGAL GUARDIAN of the colt MUST complete and submit this form for EACH Colt to be enrolled in the club. When you have finished enrolling all Colts, you will be automatically redirected to the payment page.

A discount is applied when multiple Colts are enrolled at the same time.

Section 1 - Parent or Legal Guardian Details

Surname

First Name

Mobile Phone Number

Email Address

Address Line 1

Address Line 2

Town/City

County

Post Code

Would you be interested in being a team manager?

Yes

Would you be interested in being an officer of the club?

Yes

What skills do you have that could help develop the club?

How did you hear about us?

Section 2 - Colt Details

Colt Surname

Colt First Name

Date Of Birth

Address Line 1

Address Line 2

Town/City

County

Post Code

Colt Mobile Phone Number

Colt Alternative Phone Number

Colt Email Address

Colt Identifies Their Gender As

Male Female Other

If Other, please state gender identified with

Was the Colt a member of the club last season?

Yes No

If a student, what School/College does the Colt attend?

Would the Colt be interested in learning or helping to coach or umpire (please state which)?

Did the Colt play for a different club last season? If so, which club?

If known, which age group will the Colt play for in the coming season?

Section 3 - Colt Medical Information

Next Of Kin

Mobile Phone Number

Relationship

If Other, please specify

Doctor's Name

Surgery Name

Doctor's Phone Number

As far as you are aware, is the Colt allergic to any medication?

Yes No

If yes, please enter details

Is the Colt taking any regular medication?

Yes No

If yes, for what reason?

Does the Colt have any long term illnesses or injuries?

Yes No

If yes, please give details

Please indicate if the Colt has a disability

Section 4 - Parental or Legal Guardian Declaration and Consent

Section 5: Additional Information

Please add any additional relevant information

Section 6: Additional Colts *

After this Colt, I have NO MORE Colts to enroll

After this Colt, I have MORE Colts to enroll

Colt Enrollment Form

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