Please confirm your child's name
Name of person completing the form
Relationship to child
Please give names of all parents/guardians who have responsibility for the child
Please give those Parents/Guardians Contact Number (s)
Code of conduct for young persons Please selectI agree to the code of conduct regarding my behaviour as the junior golferI disagree to the to the code of conduct regarding my behaviour as the junior golfer

Code of Conduct for parents/carers of young golfers Please selectI agree to the terms on behalf of my child and myselfI do not agree to the terms

I confirm that my child has my permission to be on the golf club’s premises. Please selectYesNo

Photography consent Please selectI consent to my child having photos, which can be published by the clubI do not consent to my child having photos, which can be published by the club

Please give details of any medical conditions, your child may have, which may require treatment
I confirm to the best of my knowledge that my child does not suffer from any medical condition other than those detailed above Please selectYesNo

Consent from parent/legal carer. I give my consent that in an emergency situation, the club may act in my place (loco parentis), if the need arises for the administration of emergency first aid and/or other medical treatment which, in the opinion of a Please selectI give my consentI do not give my consent

Do you consider your child to have a disability and if yes, then what is the nature of that disability
Does your child have any communication needs and if yes, what are those needs
Does your child have any allergies or specific dietary requirements
Does your child have any additional needs e.g. needs help to administer planned medication, assistance with lifting or access, regular snacks
I agree to notify the Club of any changes to this information Please selectYesNo

Confirm

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