Sussex County Golf Ltd

+44 (0) 1273 857 733

countyoffice@sussexgolf.org

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East Sussex National

Seaford Golf Club

Bognor Golf Club

Cooden Beach Golf Club

Cowdray Park Golf Club

Dale Hill

Dyke Golf Club

Hill Barn Golf Club

Horsham Golf Club

Mid Sussex Golf Club

Piltdown Golf Club

Rustington Golf Club

Sedlescome Golf Club

Singing Hills

West Hove Golf Club

Willingdon Golf Club

Worthing Golf Club

Highwoods Golf Club

East Sussex National

Seaford Golf Club

Bognor Golf Club

Cooden Beach Golf Club

Cowdray Park Golf Club

Dale Hill

Dyke Golf Club

Hill Barn Golf Club

Horsham Golf Club

Mid Sussex Golf Club

Piltdown Golf Club

Rustington Golf Club

Sedlescome Golf Club

Singing Hills

West Hove Golf Club

Willingdon Golf Club

Worthing Golf Club

Highwoods Golf Club

Parental Consent Form

All junior golfers who take part in any Sussex County Golf activity MUST have a parental consent form completed.

All details from the form below are confidential and only accessible to Sussex County Golf staff, approved officials
and Coaches for the purpose of keeping juniors safe.

Please contact countyoffice@sussexgolf.org if you have any questions regarding the form.

Junior's Name
Gender Male
Female
Non-binary
Prefer not to say

Home Golf Club
Date of Birth
Parent / Guardian Name
Address
Relationship to child
Parent / Guardian Email address
Parent / Guardian Contact number

Emergency Contact Name 1
Relationship to child
Work Telephone Number
Mobil Telephone Number
Home Telephone Number

Emergency Contact Name 2
Relationship to child
Home Telephone Number
Mobil Telephone Number
Work Telephone Number
Please confirm details of all those with Parental Responsibility for the Child.

Registered Doctor's Name and Address
Doctor Surgery Contact Number
Does your child experience any conditions requiring medical treatment and/or medication?

If yes, please give details, including medication, dose and frequency.
Does your child have any allergies?

If yes please give details.
Does your child have any specific dietary requirements?

If yes please give details.
What additional needs, if any, does your child have e.g. needs help to administer planned medication, assistance with lifting or access, regular snacks?
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 this golfer to have a d Visual Impairment
Hearing Impairment
Physical Disability
Learning Disability
None
If yes what is the nature of the disability?
I agree to notify Sussex Golf of any change in medical information or allergies.
I agree to notify Sussex Golf of any change in medical information or allergies.
I confirm to the best of my knowledge that my child does not suffer from any medical condition other than those detailed above.
I give my consent that in an emergency situation, the county may act in my place (loco parentis), if the need arises for the administration of emergency first aid and/or other medical treatment which, in the opinion of a qualified medical practitioner, ma

I agree that I will denote that my child has my permission to be on the premises where county activities are taking place.
I acknowledge that the county is not responsible for providing adult supervision for my child, except for formal junior golfing coaching, matches or competition.
I agree to my child being transported by county representatives to and from venues when he/she is representing the county.
I confirm that I have legal responsibility for my child (this form is for) ; I am entitled to give this consent and I am aware of how the information I have provided may be used.
By submitting this form, you are effectively signing this form as consent.
This form is to be signed by the legal carer of a child under the age of 18, together with
the child. Please note that if you have more than one child registered you will need to
complete separate forms for each.

SUSSEX COUNTY GOLF recognises the need to ensure the welfare and safety of all
children in golf. As part of our commitment to ensure their safety we will not permit
photographs, video images or other images of your child to be taken (except where some
incidental inclusion may not be possible to avoid) or used without your consent.

SUSSEX COUNTY GOLF will ensure that any image of a child where consent has not been
obtained will not be published.

SUSSEX COUNTY GOLF will follow the guidance for the use of images of children as
detailed within the Safeguarding Children and Young Peoples Policy.

SUSSEX COUNTY GOLF will take steps to ensure these images are used solely for the
purposes for which they are intended i.e. the promotion and celebration of the activities
of the county.

If you become aware that these images are being used inappropriately you should inform
the County Welfare Officer immediately.

The photographs may be available on the Sussex County Golf Website, Sussex County Golf Facebook and Sussex County Golf Instagram for the golf
season 2025. If at any time either the parent/ carer or the child wishes the data to be
removed from the website, 7 days’ notice must be given to the County Welfare Officer
after which the data will be removed.

I (Parent/Guardian) consent to Sussex County Golf photographing or videoing my child (this form is for) 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 (Child full name) consent to Sussex County Golf photographing or videoing child under the stated rules and conditions.
Confirm

Sponsor of the Inter Club Scratch Knockout Tournament

Sussex County Golf

Dyke Golf Club

Devils Dyke Road

Brighton

BN1 8YJ

+44 (0) 1273 857 733

countyoffice@sussexgolf.org

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