Junior Profile and Parental Consent

Player Profile Form Template GCGU

(For Players Under the Age of 18)

The safety and welfare of juniors in our care is paramount, and it is therefore important that we are aware of any illness, medical condition, and other relevant health details so that their best interests are addressed.

In compliance with the Data Protection Act 1998, all efforts will be made to ensure that information is accurate, kept up to date and secure, and that it is used only in connection with the purpose and activities of the organisation. Information will not be kept once a person is no longer a member of the organisation. The information will be disclosed only to those members of the organisation for whom it is appropriate and relevant officers of Wales Golf where necessary.

It is the responsibility of the junior and their parent to notify the GCGU Welfare Officer (WO) or Secretary if any of the details change at any time.

Junior Name(Required)

Date of Birth(Required)

Address(Required)

Telephone Number(Required)

Parents

Parents name #1

Parents name #2

Address #1(Required)

Address #2 (If different)

Home Telephone No #1(Required)

Home Telephone No #2

Mobile Telephone No #1(Required)

Mobile Telephone No #2

Work Telephone No #1(Required)

Work Telephone No #2

Email Address #1(Required)

Email Address #2

Emergency Contacts

Emergency Contact 1 Name(Required)

Emergency Contact 1 Work Telephone(Required)

Emergency Contact 1 Relationship to child(Required)

Emergency Contact 1 Home Telephone Number(Required)

Emergency Contact 1 Mobile Telephone Number(Required)

Emergency Contact 1 Work Telephone Number(Required)

Emergency Contact 2 Name(Required)

Emergency Contact 2 Work Telephone(Required)

Emergency Contact 2 Relationship to child(Required)

Emergency Contact 2 Home Telephone Number(Required)

Emergency Contact 2 Mobile Telephone Number(Required)

Emergency Contact 2 Work Telephone Number(Required)

Please confirm details of all those with Parental Responsibility for the Child.(Required)

Medical Information

Child’s Doctor’s name(Required)

Doctor’s Surgery Address(Required)

Doctor's Telephone Number(Required)

Does your child experience any conditions requiring medical treatment and/or medication?(Required)

Yes

*If yes please give details, including medication, dose and frequency.

Does your child have any allergies?(Required)

Yes

*If yes please give details of allergies

Does your child have any specific dietary requirements?(Required)

Yes

*If yes please give details of dietary requirements

What additional needs, if any, does your child have e.g. needs help to administer planned medication, assistance with lifting or access, regular snacks?

Disability

The Equality Act 2010 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 child to have a disability?(Required)

Yes

*If yes what is the nature of the disability?

Does your child have any communication needs e.g. non-English speaker/ hearing impairment/ sign language user/ dyslexia/neurodiversity? If yes, please tell us what we need to do to enable them to feel comfortable, supported and able to communicate effectively.

Consent from Parent/Legal Carer:

By signing this document I confirm that I have legal responsibility for the junior listed in this form; I am entitled to give this consent and I am aware of how the information I have provided may be used.

Signature(Required)

Print name(Required)

Date(Required)