Junior Day Camp Health & Safety Form

Please complete one form for each child before attending an AndyTaylorGolf day camp. The information supplied helps us provide a safe, appropriately supported and enjoyable coaching environment.

Please provide complete and up-to-date medical, allergy, medication, emergency-contact and collection information.

Child and Parent Information

Fields marked as required must be completed. Your information will be used to administer the camp, safeguard your child and respond appropriately in an emergency.

Name

Child's full name

Child's date of birth

Parent or guardian full name

Parent or guardian mobile number

Emergency contact name

Emergency contact mobile number

Relationship to child

Medical conditions, injuries or additional needs

Allergies, intolerances or dietary requirements

Medication required during the session

Does your child carry an inhaler, EpiPen or other emergency medication?

Yes

Is there anything else we should know to keep your child safe and supported?

Photographic and video consent

Yes — I give permission for appropriate photographs or video to be used for AndyTaylorGolf promotional, educational and social media purposes

No — I do not give permission for photographs or video of my child to be used

Emergency first aid consent

Emergency medical treatment consent

Collection arrangements or authorised adults

I confirm that the information supplied is accurate and I will inform AndyTaylorGolf of any changes before the camp

By submitting this form, you confirm that you have parental responsibility or authority to provide this information and consent. Please contact AndyTaylorGolf promptly if any information changes before the camp.

Junior Day Camp Health & Safety Form

Child and Parent Information

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