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2019 Summer Monday coaching - Long Island Location

Start Date: June 10th
Location: 85 Ketchams Rd, Hicksville, NY 11801
Start Time: Mon 5:30 pm 


Fees $200 (10 classes)


Online Registration

Child 1

Child 2

Parent or Legal Guardian Info

Emergency Contact


CONSENT FOR USE OF PERSONAL INFORMATION, COMMERCIAL MESSAGES AND PHOTO RELEASE I, the participant and/or parent/guardian, grant permission to Queens United Cricket Academy to photograph and/or record my or my child/ward’s image and/or voice on still or motion picture film and/or audio tape, and to use this material to promote Cricket QUCA through the media of newsletters, websites, television, film, radio, print and/or display form. I understand that the audio/visual material and copyright will remain the sole property of Queens United Cricket Academy and I waive any claim to remuneration for use of audio/visual materials used for these purposes. Furthermore, I, the participant and/or parent/guardian, authorize Queens United Cricket & Academy (QUCA) to collect and use personal information about me or my child/ward for the purpose of receiving communications (newsletters, publications, announcements, invitations and other news or information) from Cricket QUCA and posting articles of interest, newsletters, promotions, statistics, images and results on Cricket Queens United Cricket Academy or Club website. This consent is in compliance with the Personal Information Protection and Electronic Documents Act. I understand that I may withdraw such consent at any time by emailing We do not sell or distribute your personal information to any other third party.


Queens United Cricket Academy (QUCA) – ASSUMPTION OF RISK AGREEMENT By signing this document you will waive certain legal rights, PLEASE READ CAREFULLY. IN CONSIDERATION of allowing my minor child/ward to participate in the competitions, programs, activities and events of Queens United Cricket Academy, I ASSURE TO YOU THAT; 1. I am the parent/guardian of the participant having full legal responsibility for decisions regarding the participant. 2. I believe that my minor/ward is physically, emotionally and mentally able to participate in the programs, activities and events of Queens United Cricket Academy (QUCA). 3. I hereby acknowledge that I am aware of the risks and hazards associated with or related to the competitions, programs, activities and events of Queens United Cricket Academy 4. . The risks and hazards include, but are not limited to injuries from: a. Physical contact with the instructor, students or other participants; b. Striking students, participants, objects or equipment ; c. Being struck by the instructor, students, participants, objects or equipment; d. Contact, colliding, falling or being struck by other participants, spectators or equipment; e. Executing strenuous and demanding physical techniques; f. Vigorous physical exertion, strenuous cardiovascular workouts, rapid movements and quick turns and stops; g. Exerting and stretching various muscle groups; h. Dry land training including weights, running, circuit training and massage; i. Extreme weather and temperature conditions which may result in heatstroke, sunstroke or hypothermia; j. Falling , walls, stands, equipment or with other participants; k. Failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment; l. Spinal cord injuries which may render me permanently paralyzed; m. Travel to and from competitive events and associated non-competitive events which are an integral part of QUCA competitions, programs, activities, and events. 5. Furthermore, I am aware that: a. Injuries sustained to my child/ward can be severe; b. My child/ward may experience anxiety while challenging himself/herself during the competitions, activities, events and programs; c. My child/ward may come into close contact with other participants; d. My child/ward’s risk of injury is reduced if he/she follows all rules established for participation; and e. My child/ward’s risk of injury increases as he/she becomes fatigued. 6. All participants are required to participate in the fund raising activities of the club which may include, but is not limited to, candy sales, sponsorship and raffles. I UNDERSTAND AND AGREE, on behalf of myself, my heirs, assigns, personal representatives and next of kin that my signing of this document constitutes that: 7. I am registering my child/ward willingly and my child/ward is participating voluntarily in these activities, events and programs. 8. My child/ward’s physical condition has been verified by a medical doctor within the past twelve months. 9. I agree that there are risks as described above and my child/ward will be exposed to these risks and hazards. 10. I agree to accept and assume all these risks and hazards and am responsible for any injury or other loss which my minor child/ward might receive while participating in these competitions, events, activities and programs. 11. If something happens to my child/ward, I RELEASE Queens United Cricket Academy and the Staff of responsibility and liability for any and all claims, demands, actions, judgements, executions and costs which might arise out of my child/ward’s participation I ACKNOWLEDGE MAKING THIS AGREEMENT I have read and understood the terms and conditions of this agreement, and by signing it voluntarily, I am agreeing to abide by these terms.

By clicking submit, I agree to the CONSENT FOR USE OF PERSONAL INFORMATION, COMMERCIAL MESSAGES AND PHOTO RELEASE, ASSUMPTION OF RISK AGREEMENT and that my Child(ren) will abide by the rule and the code of conduct of the QUCA.

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Thanks for registering with QUCA

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