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PARENTAL CONSENT
2015 WARWICKSHIRE MENS AMATEUR
CHAMPIONSHIP
36 HOLE STROKE PLAY COMPETITION
Thursday 21st May 2015 at Copt Heath Golf Club
1220 Warwick Road, Knowle, Solihull, West Midlands, B93 9LN
Handicap Limit : 5 (see 2015 Conditions of Entry & Play attached)
Entries close on Wednesday 6th May 2015
ENTRY FEE £29 PER PLAYER, INCLUDING LUNCH
Entry Applications MUST BE made EITHER ONLINE on the County Championships website:
www.warwickshiregolf.com or by the completion and return of this POSTAL Entry Application form.
Where the player will be UNDER 18 on the day of the event Parental Consent is required.
In such instances please complete EITHER the Parental Consent Section opposite
OR the equivalent On-line Parental Consent at :
www.warwickshiregolf.com/parental_consent
(ONLY REQUIRED FOR PLAYERS AGED UNDER 18)
MEDICAL CONSENT
In caring for the best interest of your child, it is important that the County is aware if he/she suffers
from any illness or medical condition, and/or whether he/she is currently receiving medical treatment
of any kind.
Please indicate below, in strictest confidence, any health-related matters (including injuries of any
kind) that you think it best that we know about. Details of any prescribed medicine with dosage,
special dietary requirements and allergies are also requested.
Emergency Contact Name:
Tel (work):
Tel (home):
Tel (mobile):
2
nd
Contact Name:
Tel:
3rd Contact Name:
Tel:
Name of NHS Doctor/GP:
Doctor’s Practice:
Doctor’s Telephone Number:
Special Medical Conditions / Allergies / Medications etc
NOTE: The Winner qualifies for, and will be expected to compete in, the English County
Champion of Champions Tournament to be held at Woodhall Spa on 13th September 2015.
Subject to the production of bone fide receipts, the WUGC Limited will contribute up to
a maximum of £150 towards the cost of competing in that tournament.
Surname:
First Name:
Address:
Post Code:
Date of Birth:
Mobile No:
Home Club:
/
/
Email Address (print clearly):
Home Phone no:
CDH No:
Exact Handicap:
Over age 18’s please provide details of any relevant medical conditions, allergies etc :
I agree to abide by the 2015 Conditions of Entry and Play attached :
Signed : _________________________________
POSTAL ENTRY APPLICATIONS
All cheques should be made payable to The Warwickshire Union of Golf Clubs Limited (or WUGC Ltd)
and must be sent with your completed postal Entry Application Form - to arrive NOT LATER THAN the
closing date.
The Draw Sheet will be emailed to all players by 14th May 2015
and will also appear on our Championships website: www.warwickshiregolf.com
NOTE: If you wish to receive a copy of the Draw Sheet by post you must also supply a 1st class
Stamped Addressed Envelope.
I consent to my child participating in events and activities organised by the County during 2015
including golf competitions, matches and coaching that may include organised transport and
overnight accommodation.
I consent to my child receiving essential medical treatment, as necessary, when a qualified medical
practitioner prescribes such treatment.
I agree that my child be bound by the code of conduct whilst in the care of the County. This
includes coaching, matches and other events, whilst representing a County team or whilst taking part
in an event which the County is organising. You can find our code of conduct on the useful links page
of www.warwickshiregolf.com.
I agree / I disagree that photographs/videos can be taken of my child during County events as
specified within the Photograph / Video guidelines detailed below. (delete as appropriate).
I agree / disagree that my child’s details can be recorded as specified within the Data Protection
guidelines detailed below. (delete as appropriate).
NOTE :
If any of the details provided above change please ensure you inform the County Secretary or
Chairman of Junior Golf as soon as you are able.
PRINT NAME OF PARENT/GUARDIAN: ________________________________________ DATE: __ / ___ / ___
SIGNATURE OF PARENT/GUARDIAN: ___________________________________________________
PLEASE RETURN THIS COMPLETED FORM TO:
Matt Nixon, WUGC Ltd., PO Box 6184, Stratford upon Avon, CV37 1NG
Tel : 01789 297198 or 0781 3932318
THIS SECTION OF FORM TO BE RETAINED BY APPLICANT
Warwickshire Mens Amateur Championship
2015 CONDITIONS OF ENTRY AND PLAY
Entry Qualifications:
To be eligible to enter, a player must:
1.
2.
3.
be in possession of an ACTIVE CONGU playing handicap not exceeding 5 at the date of
application.
(Note : exception may be made for players who have represented County 1st or 2nd Teams in
the previous calendar year)
be a playing Member of a Warwickshire Golf Club affiliated to the County Golf Union.
obtain the permission of the County Secretary if he has represented another County, or played
in another County's Championships during the preceding 12 months.
Rules of Golf Applicable:
The Competition will be played in accordance with the Rules of Golf as approved by the
Royal and Ancient Golf Club of St Andrews, and as supplemented by Local Rules.
Note: The use of Distance Measuring Devices which conform with the current Rules of Golf
are allowed.
Resolution of Issues:
Any questions arising as to Entry Qualifications, Rules of Golf, Resolution of Exceptional Ties
or any other points will be considered by the Championship Committee whose decision will
be final. The Committee reserve the right to limit the number of entries.
PHOTOGRAPH / VIDEO CONSENT
The County recognises the need to ensure the welfare and safety of all children in golf.
Conditions of Play:
1.
2.
3.
4.
5.
6.
7.
The Championship shall be played by Stroke Play over 36 holes.
The Winner will be the competitor who returns the lowest Gross score over 36 holes.
In the event of a tie for first place after the specified number of holes, the Championship shall
be decided on the day by play-off, over holes as specified by the Championship Committee,
and if still tied, by a sudden death play-off over the same holes.
Other ties will be decided on a count back basis taking into account the Gross score for the
second round or, if necessary, on the last 9, 6, 3 and 1 holes, in sequence, until a result is
obtained. If this does not produce a result the scores on earlier holes will be taken into
account on a similar basis until a result is obtained.
The use of ride-on buggies is generally prohibited in Warwickshire Union of Golf Club events.
Players should walk at all times unless permission to ride has been given by the Championship
Committee. Permission will only be given in exceptional circumstances.
Mobile telephones are not permitted to be used on the course, except in case of emergencies.
Caddies are allowed.
Prizes:
1.
2.
3.
4.
5.
6.
7.
8.
The Winner will hold The Carl Bretherton Vase for one year, and will receive a Silver medal
and a Voucher. He will also qualify for, and be expected to compete in, the English County
Champions of Champions Tournament to be held at Woodhall Spa on 13th September 2015.
The Runner-up will receive a Bronze medal and a Voucher. 3rd Place will receive a Voucher.
Other prizes may be awarded at the discretion of the Championships Committee.
The Warwickshire Union Team Challenge Shield and Vouchers will be awarded to the club
team returning the Lowest Aggregate Gross scores. In the event of a tie the winners will be
decided on a count back basis taking into account the Gross score for the second round or, if
necessary, on the last 9, 6, 3 and 1 holes, in sequence, until a result is obtained. If this does
not produce a result the scores on earlier holes will be taken into account on a similar basis
until a result is obtained.
The Winners qualify for, and will be expected to compete in, the English Champion Club
Tournament to be held at Brancepeth Castle Golf Club, Durham on 19th & 20th September
2015.
Prize Winners and all other competitors are expected to be present at the prizegiving.
The 8 players returning the best Gross scores over 36 holes will qualify to play in the
Warwickshire Matchplay Championship for the T.P.Cooke Challenge Cup to be played at Copt
Heath Golf Club on 29th and 31st May 2015.
The 25 players returning the best Gross scores over 36 holes will qualify to play in the
Warwickshire Mens Open Championship to be played at Harborne Golf Club on Wednesday 9th
September 2015.
Dress Code After Play:
After play all competitors are required to change from their on course attire into appropriate
attire as specified on the Draw Sheet.
As part of our commitment to ensure their safety we will not permit photographs, video or other
images of your child to be taken or used without your consent.
Where your consent has been given the County will take steps to ensure that these images are used
solely for the purposes for which they are intended i.e. the promotion and celebration of the activities.
DATA PROTECTION ACT
Please note the information supplied will be kept in strictest confidence on a database and only be
used by Committee members of the County for the purposes of organising competitions, coaching,
matches or other activities for the Junior Section [including results published in the press] and will not
be disclosed to any third party.