Clubhouse Accommodation Form
This form is to ensure Club leaders have a record of who is staying at the Clubhouse along with contact details in case of an emergency or callout.
All information provided on this form will be used solely for its intended purpose by the club and will otherwise be kept confidential.
Please note that this form is for staying at the Clubhouse. If you would like to stay at the Club's Residence, please contact Carole at secretary@woolamaibeach.asn.au to book.
Member Category
Junior Member (U18)
Senior Member (18+)
!! Accommodation Form for Junior Members must be completed by the member's parent or guardian
Members Under 15
Members under 15 years of age are permitted to stay at the clubhouse on the condition that a parent or guardian also stays at the clubhouse.
Members aged 15 to 17
Members who are 15, 16 or 17 are permitted to stay at the clubhouse on the condition that their parent or guardian signs the acknowledgement below and have confirmed with a senior member of the club who has agreed to provide supervision during the junior's stay.
Members aged 18+
Adult members are permitted to stay at the clubhouse on the condition that they have completed this form.
Member age
*
Under 15
15 - 17 years old
Name of member staying at the club
*
First Name
Last Name
Mobile Number
*
To allow Club leaders to contact the staying member in case of an emergency
Email Address
*
A form submission confirmation will be sent to this address.
Check-in Date
*
-
Day
-
Month
Year
Date of arrival at the Clubhouse
Check-out Date
*
-
Day
-
Month
Year
Date of departure from the Clubhouse
Purpose of stay
*
In case of an emergency, are there any medication/health conditions Club leaders should be aware of?
Staying Member Acknowledgement: I acknowledge and accept that I must act in accordance with the Club's Code of Conduct and in a manner appropriate of a member of Woolamai Beach SLSC.
*
I acknowledge and accept
Staying Member Acknowledgement: I acknowledge and accept that if I breach the Code of Conduct, I will be required to collect my belongings and leave the clubhouse.
I acknowledge and accept
Club Member Acknowledgment
*
Parent or Guardian Name
Parent or Guardian Mobile Number (emergency contact)
To allow Club leaders to contact the member's parent or guardian in case of an emergency or incident.
Name of senior member providing supervision (you have contacted this person and they have agreed to provide supervision of your child)
I have advised this person of any parent or guardian imposed restrictions that apply to my child.
Name of Parent or Guardian staying at the clubhouse with the U15 member
Staying Parent or Guardian staying at the clubhouse needs to be a financial member of the club.
Parent or Guardian Acknowledgement: I acknowledge and accept that if my child is involved in an incident/breaches the Club's Code of Conduct, I will be required to collect them.
*
I acknowledge and accept
Parent or Guardian Consent: I authorise my child being transported by Club or private vehicles during their stay at the Clubhouse.
I accept and authorise by child being transported
I do not authorise and I have made this clear to the senior member providing supervision
Parent or Guardian Permission (If member is under 18 years of age)
Submit
Should be Empty: