Competition on the Following Page, Signed and Enclosed Your Entry Fee

/ GIRLS’ CHAMPIONSHIP – 36 hole medal play
2017 SOUTH REGION / Entry Form
Event Information
VENUE: / HENDON GOLF CLUB Ashley Walk, Devonshire Road, Mill Hill, London NW7 1DG
DATE: / Monday, 24th July 2017
ENTRY FEE: / £40 includes light lunch / CLOSING DATE: / 3rd July 2017
and tea after 36 holes
MAXIMUM FIELD SIZE: / 66 / HANDICAP LIMIT: / No handicap limit (but higher
players may be balloted out)
PRIZES: / Championship & Scratch / SEND ENTRIES TO: / Mrs Diana Rowlands
Prizes / 3 Meadowbank Close,
Handicap Trophy & Prizes / Bovingdon, Herts
Under 15 Trophy & Prize / HP3 0FB
(36 holes)
Under 13 Trophy & Prize / E: drowlands&helpplc.com
(18 holes)

PLEASE COMPLETE THE DETAILS BELOW AND ENSURE YOU HAVE READ THE CONDITIONS OF THE

COMPETITION ON THE FOLLOWING PAGE, SIGNED AND ENCLOSED YOUR ENTRY FEE.

To be completed by the entrant, please use CAPITALS

NAME: / DATE OF BIRTH:
ADDRESS:
POSTCODE:
TEL NO: / MOBILE:
EMAIL: / HOME GOLF CLUB:
CDH No: / HANDICAP:
Any special dietary requirements

……………………………………………………………………………………………………………………………………………………………………………..

I have read the conditions and enclose the entry fee along with this entry form for the above event

Players’ signature: ______

Date: ______Entry fee: £ ______

GIRLS’ CHAMPIONSHIP – 36 hole medal play

2017 SOUTH REGION Entry Form

VENUE: / HENDON GOLF CLUB Ashley Walk, Devonshire Road, Mill Hill, NW7 1DG
DATE: / Monday, 24th July 2017

CONDITIONS / QUALIFICATIONS AND FURTHER INFORMATION:

·  Competitors must be aged under 18 on 1st January 2017

·  A current CONGU ‘Competition’ handicap certificate must be produced on the day.

·  Competitors must be a member of an affiliated Club in Hampshire, Kent, Middlesex, Surrey or Sussex.

·  Players are not allowed a caddie during the competition

·  Distance Measuring Devices may be used in accordance with Rule 14.3

·  Buggies may only be used with the express permission of the Committee

·  No refunds will be given after the draw is made

·  Play will be from the red tee markers

·  A klaxon will be used in the event of adverse weather conditions

·  The committee reserves the right to alter the conditions of play and its decision will be final

·  Parents/Guardians/Relatives/Supporters/County Officials are not permitted to advise their child or influence their child’s game during a round

·  Please ensure you enclose a cheque for £40 (made payable to MLCGA and dated 3rd July 2017)

·  Please ensure you enclose a completed Medical Consent Form (for under 16s)

·  Start sheets will be posted on the website week ending 7th July at the latest. Please check for changes after this date.

·  Play will be in 3 balls if possible and from the 1st and 10th tee

·  There is a halfway house on the course with toilet facilities.

·  You will be asked for your choice of sandwich for lunch at registration in the morning

·  The entry fee includes both lunch as above and cake/squash after the day’s play

·  Please advise any dietary requirement on bottom of entry form

EG South Region

Girls Championship 2017
HENDON GOLF CLUB Ashley Walk, Devonshire Road, Mill Hill, NW7 1DG
Health & Safety Legislation
CONSENT FORM (under 16s ONLY) / Please print clearly
FULL NAME / CLUB
ADDRESS / HOME TEL NO.
MOBILE
D.O.B
E-MAIL / N.H.S. NUMBER
PLEASE INDICATE WHO SHOULD BE CONTACTED IN CASE OF AN EMERGENCY
NAME / RELATIONSHIP
HOME TEL. NO. / WORK TEL. NO.
MOBILE / E-MAIL
ALTERNATIVE / RELATIONSHIP
MOBILE
DOES SHE HAVE ANY SPECIAL MEDICAL PROBLEMS? PLEASE GIVE DETAILS OF ANY MEDICATION USED
CONDITION / YES OR NO / MEDICATION
DIABETES
EPILEPSY
MIGRAINE
ASTHMA
HAY FEVER
IF YES, PLEASE SPECIFY
IS SHE ALLERGIC TO PENICILLIN OR ANY OTHER MEDICINE?
IF YES, PLEASE SHOW SUBSTITUTE NORMALLY USED
IS SHE CURRENTLY RECEIVING ANY MEDICAL TREATMENT?
IF YES, PLEASE SPECIFY
IS HER TETANUS INJECTION UP TO DATE? / EXPIRY DATE:
PLEASE INDICATE ANY OTHER MEDICAL CONDITIONS OR
PROBLEMS YOU FEEL THAT WE SHOULD BE AWARE OF
DOCTOR / TEL. NO.
ADDRESS

I consent to my daughter taking part in this golf event under the auspices of the MLCGA.

In the unlikely event of an accident or illness requiring emergency medical, hospital or dental treatment, I authorise MLCGA or its agents to sign on my behalf any written form of consent required by a hospital, medical or dental authority if delay in obtaining my signature is considered inadvisable by the doctor, dentist or surgeon.

(In any such eventuality every attempt would be made to contact you.)

I consent that should my child win any competition, their photo may be published in related sports websites, newspapers or magazines.

PARENT/GUARDIAN’S NAME

(PLEASE USE CAPITALS)

SIGNATURE

DATE