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Parental Consent Form

I am committed to the safety and welfare of juniors during Golf coaching and the activities I organise. It is therefore important that I am aware of any illness, medical condition and other relevant health details of the Junior so that their best interests are addressed.

Please complete this form to provide me with all the relevant details and your consent as a parent or guardian. There is also a section to complete regarding the use of photography.

All information gathered is for the sole use of Zoe Allen Golf and will not be passed on to any other body and will be regarded as strictly private & confidential.

Please ensure that I am notified if any of the details change at any time.

Parental Consent Form

Golfer's Details

Golfer's Name

Golfer's Gender and Date of Birth

Gender *

Golfer's address details

Golfer's contact details

Use the same postal address for Parent or Guardian?

Parent or Guardian's contact details

Emergency contact details

Emergency contact #1

Emergency contact #2

Medical Information

Doctor's Details

Doctor's Address

Medical Conditions / Allergies / Dietary Requirements

Does your child experience any conditions requiring medical treatment and/or medication? *
Does your child have any allergies? *
Does your child have any specific dietary requirements? *

Disability

Do you consider your child to have a disability? *

Communication

Does your child have any communication needs e.g. non-English speaker / hearing impairment / sign language user / dyslexia? *

Photography

Declaration