Lunchtime Golf Club with Fr. Rich

Friday Golf with Fr. Rich

Parental/Guardian consent and risk acknowledgment for student participation at Cloverdale Catholic School- DUE BY SEPTEMBER 24, 2026
Please read the contents of this form. Clarify any questions or concerns with the lead teacher BEFORE signing it. If this form is not signed and returned to the school your child will not be permitted to attend.

Students are invited to join the Cloverdale Catholic School Golf Program with Fr. Rich. Participants will learn and practise basic golf skills in a fun, positive, and welcoming environment.

If your child signs up for one of the scheduled sessions, they are welcome to bring their own clubs, if they have them.

Time: Lunchtime (12:00 p.m. until dismissal)
Location: CCS track field (good weather) or CCS gym (bad weather)
Registration fee: $10 per student (for the year) - please send cash to school in a marked envelope "Golf Club" with your child's name and grade
Sign-up deadline: September 24

October 2 — Grade 3&4
October 16 — Grade 5&6
November 13 — Grade 7
November 27 — Grade 3&4
December 4 — Grade 5&6
December 11 — Grade 7
Board Responsibilities
The school board will ensure:
- Staff and volunteers are suitably trained and qualified.
- Students are adequately supervised.
- Locations and equipment are appropriate and safe.
- Safety and emergency plans are in place.
Potential Known Risks
• Injuries from falling, running, or transportation to and from events.
• Other risks inherent to athletic activities.
Consent and Acknowledgement of Risk
• I acknowledge my right to obtain further information about this activity and associated risks.
• I freely and voluntarily assume the risks inherent in this activity and understand that my child/ward may suffer personal injury.
• My child/ward will abide by all rules and instructions from staff and supervisors.
• Failure to follow rules may result in exclusion from the activity and I assume all related costs.
• I will advise the Lead Teacher of any medical or health concerns affecting participation.
• I consent that the board, through its employees, may secure emergency medical advice and services as necessary and I am financially responsible for any related costs.
Name of Student

Last NameFirst Name
Grade
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
If permission is granted above, my child/ward’s identity may be revealed in descriptive text or commentary.
Consent to ParticipateI have read and understood the information and acknowledge the risks. I give permission for my child/ward to participate in the Golf Club
Date of Consent

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Name

First NameLast Name
Parent/Guardian Signature
Emergency Contact - Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact - Day Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact - Evening Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact - Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

Friday Golf with Fr. Rich