Hayling Golf Club

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Perental Consent Form

Emergency Contacts
Contact Name 1
Contact Number
Relationship to Child
Contact name 2
Contact Number
Relationship to Child
Medical Information
Child's Doctors Name
Doctors Surgery Address
Doctors Telephone Number
Does your child experience any conditions requiring Medical treatment and/or medication? Yes
No
If yes please give details.
Does your child have any allergies? Yes
No
If yes, Please provide details
Does your child have any dietary requirements? Yes
No
If yes, please provide details
What additional needs, if any, does your child have e.g. needs help to administer planned medication, assistance with lifting or access, regular snacks?
Disability
The Equality Act 2010 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 child to have a disability? Yes
No
If yes what is the nature of the disability?
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
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.
I confirm that i have read and agree with the code of conduct for young Golfers
Code of Conduct for Young Golfers

Confirm

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