Hawick Golf Club CONSENT FORM

Hawick Golf Club values the involvement of children in our sport. We are committed to ensuring
that all children have fun and stay safe whilst participating in golf.
To help us fulfil our joint responsibilities for keeping children safe the golf club has introduced
Good Practice Guidelines. These Guidelines tell you what you can expect from us when your
child participates in golf and details the information we need from you to help us keep your
child safe.
We need you to you complete this form at the start of every season and to let us know as
soon as possible if any of the information changes. All information will be treated with
sensitivity, respect and will only be shared with those who need to know e.g., a team manager
or first aider.

Name Of Child:
Date of Birth:
Address:
Telephone Number:

Parents’ Names:
Address: (if different to above)
Home Telephone Number:
Mobile Telephone Number:
Work Telephone Number:

Emergency Contacts
Contact 1
Name:
Relationship to child:
Home Telephone Number:
Mobile Telephone Number:
Work Telephone Number:

Contact 2
Name:
Relationship to child:
Home Telephone Number:
Mobile Telephone Number:
Work Telephone Number:
Medical Information
Child’s Doctor’s Name:
Doctor’s Surgery Address:
Telephone Number:

Does your child have any pre-existing medical conditions that may
affect the child’s participation in golf? YES* NO

*If ‘YES’ please give details, including medication, does and frequency.

Does your child have any existing injuries? YES* NO

*If ‘YES’ please give details, including injury sustained and treatment received):
Does your child have any allergies: YES* NO
*If ‘YES’ please give details:
I consent to my child receiving medical treatment, including anaesthetic, which the medical
professionals present consider necessary. (Please tick the box if agreed).

Transportation Of Children
I consent / I do not consent (delete as appropriate) to my child being transported by persons
representing the golf club or one of its individual members or affiliated clubs for the purposes of
taking part in golf.
I understand the golf club will ask any person using a private vehicle to declare that they are
properly licensed and insured and, in the case of a person who cannot so declare, will not
permit that individual to transport children.