South Burnett Girls Cricket Carnival

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* 1. Participant name

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* 2. Participant DOB

DD/MM/YYYY

Date

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* 3. What is the participants current cricket experience?

Currently playing junior club cricket

Currently participating in a Cricket Blast program

Has played at school/home

This is the participants first time playing cricket

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* 4. Parent/Guardian Name

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* 5. Parent/Guardian Phone Number (emergency contact)

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* 6. Parent/Guardian Email Address

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* 7. Does your child have an illness or allergy for which medication is required? If yes, please specify

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* 8. PHOTO RELEASE
I hereby grant permission for Queensland Cricket to use photographs and/or video of the participant taken on the day in online posts, and in other communications related to increasing girls cricket participation.

Yes

No