Junior Open 2024 Entry Form

Name of player
 /   / 
 To enable us to care for the best interest of your child, it is important that we know whether he/she suffers from any medical condition or illness, or whether she/he is currently receiving medical treatment of any kind.

Please indicate below, in confidence, any health related matter which you think it is best we know about, including the details of any prescribed dosage or special dietary requirements:
Consent of Parent or Guardian
 My child is in good health and I consent to her/him participating in golf events.
I consent to my child receiving essential medical treatment, as necessary, when a qualified practitioner prescribes the treatment.
 This form will be kept until the end of 2022 and will then be shredded.
No information held on this form will be passed to a third party.
I consent to my child being photographed for possible inclusion in Dorset County Golf Union Books
Payment Details - Please tick if you are transferring the entry fees via a BACS payment to
 Please use your surname as the reference followed by JO 
Payment Details - Cheque
 Cheque to be made out to: Knighton Heath Golf Club Ltd 
Payment Details - By secure online portal
 Lloyds Bank 
  *Indicates a field you must enter.

Entry will only be confirmed upon receipt of payment 

When you have completed the form, please click the SEND button below

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