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Total £75.00 Young Leaders Region-- Select Your Region --BerkshireBexleyBromleyBuckinghamshireCambridgeshireCricket East, Bedfordshire, HuntsEssexGreenwichHertfordshireKentLewishamMiddlesexNorfolkSuffolkSurreySussexOther Club/School/Organisation (Berkshire)-- Select Your Club --Binfield Cricket ClubBoyne Hill Cricket ClubCookham Dean Cricket ClubCrowthorne and Crown Wood Cricket ClubFarnham Royal Cricket ClubFinchampstead Cricket ClubHungerford Cricket ClubKidmore End Cricket ClubLittlewick Green Cricket ClubMaidenhead and Bray Cricket ClubMortimer West End Cricket ClubPeppard Stoke Row Cricket ClubPinkneys Green Cricket ClubPurley- on-Thames Cricket ClubReading Cricket ClubRoyal Ascot Cricket ClubShinfield Cricket ClubSlough Cricket ClubSonning Cricket ClubTheale and Tilehurst Cricket ClubTwyford & Ruscombe Cricket ClubUxbridge Cricket ClubWaingels Cricket ClubWarfield Cricket ClubWargrave Cricket ClubWest Ilsley Cricket ClubWraysbury Cricket ClubOther Club/School/Organisation (Bexley)-- Select Your Club --Bexley Cricket ClubBexleyheath Cricket ClubSidcup Cricket ClubOther Club/School/Organisation (Bromley)-- Select Your Club --Beckenham Cricket ClubBromley Cricket ClubBromley Common Cricket ClubBromley Town Cricket ClubChislehurst&West Kent Cricket ClubDownham&Bellingham Cricket ClubHayes Cricket ClubNew Beckenham Cricket ClubOD Cuaco Cricket ClubOld Elthamians Cricket ClubOld Wilsonians Cricket ClubOrpington Cricket ClubOther Club/School/Organisation (Buckinghamshire)-- Select Your Club --Amersham Cricket ClubAston Clinton Cricket ClubBallinger Wagoners Cricket ClubBeaconsfield Cricket ClubBledlow Ridge Cricket ClubBledlow Village Cricket ClubBuckingham Cricket ClubBuckland and Aston Clinton Cricket ClubBurnham Cricket ClubChalfont St Peter Cricket ClubChenies and Latimer Cricket ClubChesham Cricket ClubCublington Cricket ClubDinton Cricket ClubFarnham Common Cricket ClubGreat Kingshill Cricket ClubHigh Wycombe Cricket ClubHolmer Green Cricket ClubLey Hill Cricket ClubMilton Keynes Cricket ClubStewkley Vicarage Cricket ClubStoke Green Cricket ClubThe Lee Cricket ClubWendover Cricket ClubWolverton Town Cricket ClubWooburn Narkovians Cricket ClubOther Club/School/Organisation (Cambridgeshire)-- Select Your Club --Cambridge Cricket ClubChatteris Cricket ClubFoxton Granta Cricket ClubHaddenham Cricket ClubHiston Cricket ClubLittle Shelford Cricket ClubMarch Cricket ClubMCC Hub CambridgeshireRoyston Cricket ClubSawston Cricket ClubSawtry Cricket ClubSt Ives & Warboys Cricket ClubSutton (cambs) Cricket ClubThriplow Cricket ClubOther Club/School/Organisation (Cricket East, Bedfordshire, Hunts)-- Select Your Club --Ampthill Town Cricket ClubBedford Cricket ClubBiggleswade Town Cricket ClubBlunham Cricket ClubClifton Cricket ClubDunstable Town Cricket ClubEaton Socon Cricket ClubElstow Cricket ClubEversholt Cricket ClubFlitwick Cricket ClubGodmanchester Town Cricket ClubHarrold Cricket ClubHoughton & Wyton Cricket ClubIckwell Cricket ClubKimbolton Cricket ClubLutonian Cricket ClubNassington Cricket ClubOlney Town Cricket ClubPavenham and Felmersham Cricket ClubPeterborough Town Cricket ClubPilgrims Oakley Cricket ClubTring Park Cricket ClubUpwood Cricket ClubWaresley Cricket ClubOther Club/School/Organisation (Essex)-- Select Your Club --Abberton and District Cricket ClubBelhus Cricket ClubBillericay Cricket ClubBrentwood Cricket ClubBrightlingsea Cricket ClubCavaliers Cricket ClubCoggeshall Town Cricket ClubCoton Cricket ClubEight Ash Green Cricket ClubFrenford Cricket ClubHadleigh & Thundersley Cricket ClubHatfield Heath Cricket ClubHigh Roding Cricket ClubHornchurch Cricket ClubHutton Cricket ClubLittle Shelford Cricket ClubLoughton Cricket ClubMistley Cricket ClubOld Chelmsfordians Cricket ClubOrsett and Thurrock Cricket ClubRainham Cricket ClubSaffron Walden Cricket ClubShenfield Cricket ClubSouthend and EOI Cricket ClubSouthend-on-Sea & EMT Cricket ClubSpringfield Cricket ClubSt Johns (Billericay) Cricket ClubStansted Hall and Elsenham Cricket ClubTheydon Bois Cricket ClubUpminster Cricket ClubWalthamstow Cricket ClubWenden Cricket ClubWest Essex Cricket ClubWest Mersea Cricket ClubWoodford Wells Cricket ClubOther Club/School/Organisation (Greenwich)-- Select Your Club --Blackheath Cricket ClubGreenwich Junior AcademyOld Colfeians Cricket ClubOther Club/School/Organisation (Hertfordshire)-- Select Your Club --Abbots Langley Cricket ClubBidborough Cricket ClubBorstal Cricket ClubBroadstairs Cricket ClubCanterbury Cricket ClubChelsfield Park Cricket ClubChestfield Cricket ClubCowdery Cricket ClubCranbrook SchoolEdenbridge Cricket ClubHolmesdale Cricket ClubInvicta Northern WarriorsInvicta Western RhinosKemsing Cricket ClubKings Hill Cricket ClubLinden Park Cricket ClubLittlebourne Cricket ClubMargate Cricket ClubMersham Cricket ClubPlaxtol Cricket ClubSevenoaks Vine Cricket ClubShoreham & Otford Cricket ClubSouthborough Cricket ClubTonbridge Cricket ClubTown Malling Cricket ClubTunbridge Wells Borderers Cricket ClubTunbridge Wells Cricket ClubWeald of Kent SchoolOther Club/School/Organisation (Kent)-- Select Your Club --Bidborough Cricket ClubBorstal Cricket ClubBroadstairs Cricket ClubCanterbury Cricket ClubChelsfield Park Cricket ClubChestfield Cricket ClubCowdery Cricket ClubCranbrook SchoolEdenbridge Cricket ClubHolmesdale Cricket ClubInvicta Northern WarriorsInvicta Western RhinosKemsing Cricket ClubKings Hill Cricket ClubLinden Park Cricket ClubLittlebourne Cricket ClubMargate Cricket ClubMersham Cricket ClubPlaxtol Cricket ClubSevenoaks Vine Cricket ClubShoreham & Otford Cricket ClubSouthborough Cricket ClubTonbridge Cricket ClubTown Malling Cricket ClubTunbridge Wells Borderers Cricket ClubTunbridge Wells Cricket ClubWeald of Kent SchoolOther Club/School/Organisation (Lewisham)-- Select Your Club --Catford Cyphers Cricket ClubCatford Wanderers Cricket ClubOther Club/School/Organisation (Lincolnshire)-- Select Your Club --Ancaster Cricket ClubAlford & District Cricket ClubBillingborough Cricket ClubBlankney Cricket ClubBoston Cricket ClubBourne Cricket ClubCaythorpe Cricket ClubFreiston, Leverton and Leake Cricket ClubFulbeck Cricket ClubGrimolby Cricket ClubHeckington Cricket ClubHorncastle Cricket ClubLong Sutton Cricket ClubLouth Cricket ClubMoulton Harrox Cricket ClubNocton Cricket ClubRevesby Cricket ClubReepham Cricket ClubRopsley Baboons Cricket ClubSleaford Cricket ClubSpalding Town Cricket ClubStamford Cricket ClubTetford Cricket ClubUffington Cricket ClubWoodhall Spa Cricket ClubOther Club/School/Organisation (Middlesex)-- Select Your Club --Brentham Cricket ClubCockfosters Cricket ClubEastcote Cricket ClubHighgate Cricket ClubHornsey Cricket ClubNorth London Cricket ClubShenley Church End Cricket ClubSouthgate Adelaide Cricket ClubStoke Newington Cricket ClubOther Club/School/Organisation (Norfolk)-- Select Your Club --Acle Cricket ClubBradenham Cricket ClubBrooke Cricket ClubGreat Melton Cricket ClubHethersett and Tas Valley Cricket ClubLangley SchoolNorwich Cricket ClubNorwich Bystanders Cricket ClubSaxlingham Cricket ClubSprowston Cricket ClubSwardeston Cricket ClubTopcroft Cricket ClubOther Club/School/Organisation (Oxfordshire)-- Select Your Club --Abingdon Vale Cricket ClubBrixworth Cricket ClubChallow Cricket ClubCharlbury Cricket ClubCumnor Cricket ClubEast & West Hendred Cricket ClubGreat & Little Tew Cricket ClubOxford Cricket ClubTiddington Cricket ClubWarborough & Shillingford Cricket ClubWolvercote Cricket ClubOther Club/School/Organisation (Suffolk)-- Select Your Club --Bardwell Cricket ClubBattisford and District Cricket ClubBlundeston and Somerleyton Cricket ClubBungay Cricket ClubBury St Edmunds Cricket ClubCastle Cricket ClubCarribeans Cricket ClubCopdock and Old Ipswichian Cricket ClubEarl Stonham Cricket ClubEaston Cricket ClubElvedon Cricket ClubEye and District Cricket ClubFelixstowe and Corinthians Cricket ClubFramlingham CollegeHadleigh Cricket ClubHaverhill Cricket ClubHundon Cricket ClubIpswich and East Suffolk Cricket ClubIpswich Cricket ClubIpswich Cricket ClubKesgrave Cricket ClubLakenheath Cricket ClubLong Melford Cricket ClubLowestoft Cricket ClubMildenhall Cricket ClubSaxmundham Sports Cricket ClubSouthwold Cricket ClubStowmarket Cricket ClubStowupland Cricket ClubSt Margarets Cricket ClubSudbury Cricket ClubTendring Park Cricket ClubThurston Cricket ClubTuddenham St Mary Cricket ClubWalsham Le Willows Cricket ClubWoodbridge Cricket ClubWoolpit Cricket ClubWorlington Cricket ClubYoxford Cricket ClubOther Club/School/Organisation (Surrey)-- Select Your Club --Banstead Cricket ClubCamberley Cricket ClubDulwich Cricket ClubEast Molesey Cricket ClubEpsom Cricket ClubFarncombe Cricket ClubFrensham Cricket ClubKenley Cricket ClubLimpsfield Chart Cricket ClubMaldon Wanderers Cricket ClubNewdigate Cricket ClubNormandy Cricket ClubOld Rutlishians Cricket ClubOxted & Limpsfield Cricket ClubReigate Priory Cricket ClubRichmond Cricket ClubRoehampton and Fulham Cricket ClubRowledge Cricket ClubSanderstead Cricket ClubSpencer Cricket ClubStreatham & Marlborough Cricket ClubSutton Cricket ClubValley End Cricket ClubWeybridge Cricket ClubWimbledon Cricket ClubOther Club/School/Organisation (Sussex)-- Select Your Club --Ansty Cricket ClubArundel Cricket ClubBACABillingshurst Cricket ClubBrighton and Hove Cricket ClubBurgess Hill Cricket ClubBuxted Park Cricket ClubChippingdale Cricket ClubCrawley Down Cricket ClubCuckfield Cricket ClubEastbourne Cricket ClubFelbridge and Sunnyside Cricket ClubGlynde & Beddingham Cricket ClubHastings Priory and St Leonards Cricket ClubHaywards Heath Cricket ClubHeathfield Park Cricket ClubHenfield Cricket ClubHerstmonceux Cricket ClubHorsham Cricket ClubHorsham Trinity Cricket ClubHurstpierpoint Cricket ClubLewes Priory Cricket ClubLindfield Cricket ClubMiddleton Cricket ClubNewick Cricket ClubNuthurst Cricket ClubPevensey Cricket ClubPreston Nomads Cricket ClubRobertsbridge Cricket ClubRoffey Cricket ClubRottingdean Cricket ClubRudgwick Cricket ClubScaynes Hill Cricket ClubSeaford Cricket ClubSt Peters Cricket ClubStirlands Cricket ClubWest Chiltington and Thakeham Cricket ClubWest Wittering Cricket ClubWest Wittering Cricket Club/Dulwich CollegeWorthing Cricket ClubOther Club/School/Organisation (Worcestershire)-- Select Your Club --Astwood Bank Oldswinford Cricket ClubCricket ClubBelborougton Cricket ClubMalvern Cricket ClubAlvechurch & Hopwood Cricket ClubMartley Cricket ClubSwindon Cricket ClubDrotwich Spa Cricket ClubPedmore Cricket ClubStourbridge Cricket ClubOther Cricket Club or nominating body (School or other) Other Cricket Club or School Your Child's Name Gender-- Select --MaleFemaleNon-binaryPrefer not to say Ethnicity (If you're unsure what to choose you can see the definition on the UK Census website)-- Select --WhiteMixed or multiple ethnic groupsAsian or Asian BritishBlack or Black BritishOther Ethnic GroupPrefer not to say Date of Birth School School Year-- Select --ReceptionYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12 Parent/Guardian Information Parent/Guardian email Parent/Guardian Home Telephone Number Parent/Guardian Mobile Number Emergency Contact Emergency Contact Number The Disability Discrimination Act 1995 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’. Do you consider your Young Leader to have a disability? -- Select --NoYes Further Support Required-- Select --YesNo Medical Conditions (including details of any recognised disability) Emergency Medical Considerations (including details of any further support required) Legal Authority to ConsentYesNo Consent to ParticipateYesNo Medical Consent: TreatmentYesNo Medical Consent: DeclarationYesNo Consent for PhotographyYesNo Accuracy of InformationYesNo Discount Code Thanks for entering your discount code. Your club will pay the registration fee. I agree to the Young Leaders in Cricket Pledge I agree to be added to the Spond platform for booking modules and ongoing communications about the programme. Add a Young Leaders Polo Shirt? (+£40.00) Total £75.00 Please check the details are correct - especially your email address - then verify and click "Submit" Δ
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