KGC 2023 Junior Summer Golf Registration Form

KGC 2023 Junior Summer Golf Registration Form
Kilkeel Golf Club Summer Golf 2023 Junior Membership Application form
Name*
Date of birth*

DayMonthYear
Date
Address*
Home Number*
Mobile Number*
Email*
example@example.com
Parent /Guardian's Name
School
Other Sports played
Has the applicant been a member of another Golf Club:
Club name
Handicap
What Kilkeel Golf Club requires of you to play the course Good behaviour and the 3 Golden Rules' - Bunkers, Divots, Pitch Marks

Polo Shirt, trousers or tailored shorts and golf shoes or trainers (No collarless T-shirts or jeans!) As per Calendar and course availability - Must be signed in at Pro-Shop prior to round
5-11 year old12-15 year old16-17 year old
Parent/Guardian's Signature (Hard copy form signature also required)
Date

DayMonthYear
Date
Kilkeel Golf Club. Mourne Park. Kilkeel, Co Down BT34 4LB - 028 417 65095 (Ext 1) info@kilkeelgolfclub.com

KGC Golf Professional Angela Kilmartin 028 417 65095 (Ext 2) angelakilmartin@aol.com
Kilkeel Golf Club Junior Player Profile Form

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 junior and their parent/guardian to notify the KGC Junior Convenor if any of the details change at any time.
Name*
Date of birth

DayMonthYear
Date
Address

Street Address

Town

Post TownCounty

Post Code
Home Number
Mobile Number*
Email*
example@example.com
Parent /Guardian's Name*
Address If different to above

Street Address

Town

Post TownCounty

Post Code
Home Number
Mobile Number*
Work Number
EMERGENCY CONTACTS
Contact 1 Name*
Relationship to child
Home Number
Mobile Number*
Work Number
Contact 2 Name*
Relationship to child
Home Number
Mobile Number*
Work Number
Medical information
Child's Doctor's Name
Address

Street Address

Town

Post townCounty

Post Code
Telephone number
YesNo
If YES, please give details, including medication, dose and frequency.
YesNo
Allergies? if Yes give details
YesNo
Dietary requirements (If Yes, please give 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?
The Disability Discrimination Act 1995 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'
YesNo
Hearing impairmentLearning disabilityPhysical disabilityMultiple disabilitiesOther (please specity)
What additional needs, if any. does your child have e.g. needs help to administer planned medication, assistance with lifting or access, regular snacks?
YesNo
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.

Being parent/guardian of the above named child, hereby give permission for the club 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 the doctor's medical opinion, for any delay to be incurred by seeking my personal consent.
I, being parent / guardian of the above named child, hereby give permission for the club 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 the doctor's medical opinion, for any delay to be incurred by seeking my personal consent.*
Name of parent/guardian
Agreed
Agreed
Agreed
Signed Parent/Guardian's (Hard Copy form signature also required)
Print Name
Date

DayMonthYear
Date
Should be Empty:

KGC 2023 Junior Summer Golf Registration Form

EMERGENCY CONTACTS

Medical information