Cornwall Golf Union

CGU Parental Consent Form

Please Note: This form applies only to the Cornwall Golf Union 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 the Cornwall Golf Union of changes in circumstances at any time. Tel: 01579 384233 or Email: secretary@cornwallgolfunion.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 Telephone Number
Mobile Telephone No.1
Mobile Telephone No.2
Gender

Email
Confirm Email address
Date of Birth
Age Group as of 1st January

Address
Post Code
Home Club
Handicap

CDH No.
Your CDH No. is a unique 10-digit number provided by England Golf. if you do not know yours, it is available from your Club Secretary or Manager. If you do not have a CDH No. yet then please enter 54 as your playing handicap.

Parents Personal Data

Title

Forename
Surname
Relationship to Child
Address
Post Code
Best Emergency Contact No.
Medical Information
Doctor's Name/Surgery
Doctor's Telephone No.
Does Your Child have any conditions requiring medical treatment and or medication

If yes please provide details incl medication with dosages and frequency
Does your Child have any allergies

If yes please provide details
Does Your Child have any specific dietary requirements

If yes please provide 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?

If yes, what is the nature of the disability
Does your child have any communication needs e.g. non-English speaker or hearing impairment or sign language user or dyslexia?

If yes what do we need to do to enable them to communicate with us in full
Photography
I give consent for images of my Child to be published across all platforms in accordance with the Cornwall Golf Union Safeguarding Children & Young People Policy

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 dietary requirement, disability or special communication need other than those entered above. Furthermore, I agree to notify the Cornwall Golf Union of any changes
b. I hereby give permission for the Cornwall Golf Unionâ€™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 the Cornwall Golf Union 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 the Cornwall Golf Union to and from venues when representing the Union

By submitting this form I confirm that I have legal responsibility 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 be used

Name
Relationship to Child
Date
Confirm

Created by intelligentgolf version 10.1.2.

CGU Parental Consent Form

Juniors

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