Mowsbury Golf Club Junior Application Form

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1 Mowsbury Golf Club Junior Application Form Important Notes: Juniors must be under the age of 18 on the 1 st January 2017 All cheques must be made payable to Mowsbury Golf Club The Junior Medal levy covers all medals played in season The Club reserve the right to post lists of Playing Members / Telephone numbers /Handicaps Contact Details (Use Block Capitals and include all Christian names) Name (Full) Address Post Code Date of Birth Other Details Home Telephone No Mobile No Address (Optional) Junior Membership Fees Insurance County/Union Fees Boys/girls Medal Levy Boys/Girls Join Total / / Details of any other Golf Club Membership (Past or Present) and include handicap details I confirm that I have read and will comply with the Code of Conduct for Young Golfers Signature of Junior Applicant: Proposed By: Signature: Seconded By: Signature: Parent/Guardian Agreement: Name Signature Please return this form fully completed with the appropriate fees to: The Secretary, Mowsbury Golf Club Tel No Mowsbury Golf Club, Cleat Hill, Kimbolton Road, Ravensden, Bedford. MK41 8BJ

2 CODE OF CONDUCT FOR YOUNG GOLFERS This code of conduct has been designed to ensure that all Young Golfers have a point of reference providing the minimum standards expected when participating in golfing activity. All Young Golfers should ensure that they are fully conversant with the code and should strive to meet the code at all times. Ensure that all golfers are able to participate in golf without fear of ridicule, harassment or restriction. Treat other golfers with the same respect and fairness you would like them to show you Demonstrate fair play on and off the course. Respect differences in gender, disability, culture, race, ethnicity, age, social orientation, and religious beliefs between yourself and others Challenge discrimination and prejudice Look out for yourself and the welfare of others Do not engage in any irresponsible, abusive, inappropriate or illegal behaviour Challenge behaviour that falls below the expected standards of the county or club Speak out if you have concerns about anything, your own needs or the needs of others Be organized and on time You must not: - Consume alcohol or illegal and performance enhancing drugs - Smoke - Use foul language - Engage in sexual behaviour - Leave the facility for any reason without advising an adult

3 PLAYER PROFILE FORM This form is to be issued to all golf club juniors so that all their details can be updated. It is important that a golf club keeps up to date contact details on all their junior members. It is also the responsibility of the junior and their parent/guardian to notify the Club Secretary if any of the details change at any time. Once the form has been completed return to The Secretary at Mowsbury Golf Club All forms need to be signed by parents/guardians Name of child: Date of Birth: / / Gender: Male Female Address: Postcode: Parent/Guardian Name: Relationship : Home Telephone: Mobile telephone: Work telephone: Emergency Contact 1: Name: Contact Telephone Numbers in order of preference: Emergency Contact 2: Name: Contact Telephone Numbers in order of preference:

4 MEDICAL INFORMATION 1. Child's Doctor's name and contact details: Name: Telephone: 2. Does your child have any conditions requiring medical treatment and/or medication? * Yes / No *If yes please give details. 3. Does your child have any allergies? 3. Does your child have any allergies? * Yes / No *If yes please give details. 4. Does your child have any specific dietary requirements? * Yes / No *If yes please give details. 5. Please provide any further information that you feel is appropriate Please provide any further information that you feel is appropriate. 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 should the above details need to be updated/changed and if my child should not be participating due to illness or injury. I, being parent/guardian of the above named child hereby give permission for the Junior Organiser/PGA Professional/Club Official 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. Signed - Parent/Guardian: Date:

5 EQUAL OPPORTUNITIES MONITORING (optional) Ethnicity A. White British Irish B. Mixed Any other white background (Please specify): White & Black Caribbean White & Asian White & Black African Any other mixed background (Please specify) C. Asian or Asian British Indian Pakistani Bangladeshi Any other Asian background (Please specify): D. Black or Black British Caribbean African Any other Black background (Please specify): E. Chinese or other ethnic group Chinese Any other (Please specify): Disability 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' Do you consider your son/daughter to have a disability? *Yes No *If yes what is the nature of their disability? Visual impairment Learning disability Hearing impairment Multiple disability Physical disability Other (Please specify):

6 By returning this completed form, I agree to my child in my care taking part in organised activities at the golf club/county. I understand that I will be kept informed of these activities, for example coaching dates & times. I understand that in the event of any injury or illness all reasonable steps will be taken to contact me, or the nominated person on this form, and to deal with that injury/illness appropriately. I have read the Young Person's Code of Conduct and agree that my child should abide by this whilst in the care of the club/county and I understand that a serious or continued breach of this code may result in my child being sent home early at my expense. Signed Parent/Guardian: Print Name: Date: Please note that this information will be held in the Secretary/Manager's office, however some of the information will need to be shared with the Junior Organiser(s)/PGA Professional who will be in charge of the coaching sessions/matches/tournaments the child in your care could be attending. Only relevant information such as emergency contact details and medical information will be shared to ensure that those responsible can act in an appropriate manner should your child require it? If you have any questions/reservations please speak to the club Secretary/Manager.

7 PARENT/GUARDIAN & YOUNG PERSON PERMISSION FORM FOR THE USE OF PHOTOGRAPHS & RECORDED IMAGES This form is to be signed by the parent/guardian of a child or young person under the age of 18, together with the child or young person. Please note that if you have more than one child under the age of 18 registered with the Club; you will need to complete separate forms for each young person. Mowsbury Golf Club recognises the need to ensure the welfare and safety of all young people in golf. As part of our commitment to ensure the safety of young people we will not permit photographs, video images or other images of young people to be taken and/or used without the consent of the parent/guardian and the young person. Mowsbury Golf Club will follow the guidance for the use of images of young people as detailed within the Children in Golf (CIG) Policy and Procedures; Mowsbury Golf Club will take steps to ensure these images are used solely for the purposes they are intended which is the promotion of the activities at Mowsbury Golf Club. If you become aware that these images are being used inappropriately you should inform the clubs Golf Welfare Officer immediately. Images may be used on the Mowsbury Golf Club website: If at any time either the parent/guardian or the young person wishes the data to be removed from the website, 7 days notice must be given to the clubs Golf Welfare Officer after which the data will be removed.

8 PARENT/GUARDIAN & YOUNG PERSON PERMISSION FORM FOR THE USE OF PHOTOGRAPHS & RECORDED IMAGES To be completed by parent/guardian I (parent/guardian full name) consent to Mowsbury Golf Club photographing or videoing (name of young person) Under the stated rules and conditions, and I confirm I have legal parental responsibility for this child and am entitled to give this consent. I also confirm that there are no restrictions relating to taking photos. Signature: Date: To be completed by Young Person I (name of young person) consent to Mowsbury Golf Club photographing or videoing my involvement in golf under the stated rules and conditions. Signature: Date:

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