Junior Player Profile & Medical Form

This player profile form, enables those responsible for the junior players, to have the information they require to fulfil their care of duty, safe-guarding obligations, and to deal with an emergency situation.
Surname of Junior Player
First Name of Junior Player
Home Address
Gender Identification Male
Female
Other
Date of Birth
Current Handicap Index
Name of Parent or Legal Guardian/Carer
Address of Parent/Guardian if different from above
Emergency Contact - Name
Emergency Contact - Phone Number
Emergency Contact 2 - Name (optional)
Emergency Contact 2 - Phone Number
Medical Information
Doctors Name & Surgery Information
Does the player have an illness, condition or allergies that require regular medication that we should be aware of? Yes
No
If Yes, please provide all relevant information below.
Does the player have any dietary requirements or food allergies that we should be aware of? Yes
No
If Yes, please provide all relevant information below.
Does the player have any additional behavioural, personal or learning needs that we should be aware of? Yes
No
If Yes, please provide all relevant information below.
Medical and Emergency Situation Consent
I give my consent, that in an emergency situation, the club staff and volunteers may act in my place, until the emergency contact is reached.
I confirm that the player does not suffer from any medical condition that has not been declared on this form.
I agree to notify Farnham Golf Club of any changes to the players information above.
General Consents & Codes of Conduct
I agree to the player attending the club and it's facilities and that the club is not responsible for providing adult supervision except for formal competitions and coaching.
I agree to the player being transported to other sites when representing the club.
I give permission for Farnham Golf Club to hold the information contained on this form for the purpose of emergency contact and safeguarding procedures.
I confirm that I have read, understood and agree to adhere to all the following documentation. Parent/Carer Code of Conduct
Club Photography Policy
Road Crossing Information
Guidance for Adult/Parents
I confirm that the junior player has read, understood and will abide by the Players Code of Conduct document and that breaches of the code may jeopardise their membership status.
Please provide any further information about the junior golfer that may assist us in providing the best possible support in their golfing journey (optional)
I DECLARE THAT I AM THE LEGAL PARENT/CARER AND THE INFORMATION ABOVE IS TRUE AND CORRECT
NAME
Email Address
DATE
Confirm

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FARNHAM GOLF CLUB LTD
Blighton Lane, The Sands,
Farnham, Surrey, GU10 1PX
Telephone: +44 (0) 1252 782109
Email: clubhouse@farnhamgolfclub.co.uk

Junior Player Profile & Medical Form

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