Parental Consent Form

Please Note: This form applies only to DevonGolf and cannot be used by any other organisation.

The safety and welfare of Juniors in our care is paramount and it is therefore important that we are aware of any illness, medical condition and other relevant health details so that their best interests are addressed.

Please complete this form with our assurance that the information will be treated as confidential. It is the responsibility of the Child or their parent to notify DevonGolf to change any details at any time. Tel: 07779 990393 or Email: info@devongolf.org.uk

In compliance with the Data Protection Act 1998, all efforts will be made to ensure that information is accurate, kept up to date and secure and that it is only used in connection with the purpose and activities of the organisation. Information will not be kept once a person is no longer a member of the organisation. information will be disclosed only to those members of the organisation for whom it is appropriate.

Childs Personal Data

Title

Forename
Surname
Home Tel No
Mobile Tel No
Gender Male
Female
Email Address
Confirm Email Address
Date of Birth
Age Group (as at 1st Jan)

Address
Post Code
Home Club

Members No:

Your Member No (formally CDH) is a unique 10 digit number provided by England Golf and is available from your Club Secretary/Manager.

If you do not have a Member Number yet, please enter 54 as your Handicap

WHS Handicap Index (nearest whole number

Parents Personal Data

Title

Forename
Surname
Relationship to Child

Address
Post Code
Emergency Contact No

Medical Information

Doctors Name/Surgery
Doctors Tel No
Does your child experience any conditions requiring medical treatment and or medication? Yes
No
If yes please give details including medication with dosages and frequency
Does your child have any allergies? Yes
No
If yes please give details
Does your child have any specific Dietary requirements? Yes
No
If yes please give details

Disability

The Equality Act 2010 defines a disabled person as 'anyone with a physical or mental impairment, which has a substantial and long term effect on their 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 eg non-English speaker or hearing impairment or sign language user or dyslexia? Yes
No
If yes what do we need to to enable them to communicate with us full

Photography

I give consent for images of my Child to be published across all platforms in accordance with the DevonGolf Safeguarding Children & Young People Policy Yes
No

Have we missed anything?

Please provide any further details that you feel we should be aware of

Declarations

a. I confirm that to the best of my knowledge that my Child does not suffer from any medical condition, allergy, special dietry requirent, disability or special communication need other than those entered above. furthermore, I agree to notify DevonGolf of any changes

b. I hereby give permission for DevonGolf's responsible person to give the immediately necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my Child's interest, in Doctors medical opinion, for any delay to be incurred by seeking my personal consent

c. My Child has my permission to be on the golf club's premises

d. I acknowledge that DevonGolf is not responsible for providing adult supervision for my child except for formal golf coaching, matches or competitions

e. I agree to my child being transported by representatives of DevonGolf to and from venues when representing DevonGolf

By submitting this form I confirm that I have legal responsibliity for the child named above and that I am entitled to give this consent and that I am aware of how the information I have provided may by used Yes

Name
Relationship to Child

Date

Confirm