Warwickshire Golf

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Warwickshire Union Junior Profile & Parental Consent Form

Parental Consent Form 2024

Childs First Name:
Childs Surname
1st Line of Address:
Town/City:
Post Code:
Date of Birth:
Parent / Guardian (1) Name:
Parent / Guardian (1) Email address:
Parent / Guardian (1) Emergency Number:
Parent / Guardian (1) Alternative Number (if applicable):
Parent / Guardian (2) Name (if applicable):
Parent / Guardian (2) Email address (if applicable):
Parent / Guardian (2) Emergency Number (if applicable):
Parent / Guardian (2) Alternative Number (if applicable)
Childs NHS Number (if available):
Name of NHS Doctor/GP:
Address of Doctor/Surgery:
Doctors Telephone Number:
Does this applicant suffer from any of the following ailments or illness: Asthma
Epilepsy
Fits or Blackouts
Diabetes
Allergy - Bee/Wasp Stings
Allergy - Nuts
None
If you have answered YES to any of the above or the applicant has any other ailment or medical condition please give further details:
I consent to my child participating in events and activities organised by the County in this calendar year, including golf competitions, matches and coaching that may include organised transport and overnight accommodation:
I consent to my child receiving essential medical treatment, as necessary, when a qualified medical practitioner prescribes such treatment:
I agree / disagree for my child to have their name included in the Squad list displayed on the County website I agree
I disagree
I agree / disagree that photographs / videos can be taken of my child during County events as detailed in our Photograph / Video policy: I agree
I disagree
I agree / disagree to the statement outlining our data protection policy: I agree
I disagree
I agree / disagree for the parent/guardian email addresses supplied within this form be used in order to provide you with information regarding golf union related activities, such as fixture dates and training: I agree
I disagree
I have read and understand the statement outlining our policy on changing rooms and toilets usage at events / coaching sessions: I have read and understand the statement regarding changing rooms and toilets
Confirm

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