Does your child have any communication needs e.g. non-English speaker/ hearing
impairment/ sign language user/ dyslexia? If yes, please tell us what we need to do to
enable him/her them to communicate with us fully.
Consent from Parent/Legal Carer:
I confirm to the best of my knowledge that my child does not suffer from any
medical condition other than those detailed above.
I agree to notify the Club of any changes to this information.
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 qualified medical
practitioner, may be necessary. I also understand that in such an occurrence all
reasonable steps will be taken to contact me or the alternative adult named in
this form.
The attached signature will denote that my child has my permission to be on the
golf club's premises.
I acknowledge that the club is not responsible for providing adult supervision for
my child, except for formal junior golfing coaching, matches or competition.
I agree to my child being transported by club representatives to and from
venues when he/she is representing the club.
(Please tick the boxes if agreed)
By signing this document I confirm that I have legal responsibility for
By signing this document I confirm that I have legal responsibility for
……………………………………………………… ; I am entitled to give this consent and I am aware of how
……………………………………………………… ; I am entitled to give this consent and I am aware of how
the information I have provided may be used.
the information I have provided may be used.
SIGNED -
PARENT /CARER:
PRINT NAME:
DATE: