Nepean Golf Association
25 Forbes St Emu Plains 2750
Telephone/Facsimile 4735 1730
Email : DougHayne@westsport.com.au
Secretary Doug Hayne
CONSENT / RECOGNITION OF RISKS FORM FOR MINORS
Consent Form For Parent/Legal Guardian (Please read carefully)
To: Secretary Nepean Golf Association
I ………………………………………………
authorise my child/ward,……………………………………………….,
to participate in the recreational activity program [operated by or called]
Nepean Golf Association and called Nepean Open Amateur, Nepean Presentation
Dinner, Nepean Mixed Foursomes and Nepean A, B, C or Mixed Pennants.
I understand that some of the activities in which they may participate:
(a) will be physically and emotionally demanding; and
(b) may involve a significant risk of physical harm.
My child’s/ward’s participation in any activity is voluntary and not
compulsory.
I understand certain inherent risks exist in the activities in which my child/ward
will be participating. Although the organisation and its members will provide
appropriate directions and will endeavour to minimise exposure to the risk of
harm, these inherent risks are beyond the control of Nepean Golf Association,
its volunteers and staff and cannot be avoided by the exercise of reasonable
care and skill.
I am aware that there are some risks that are common to many or all of the activities
in which my child/ward may participate. However, some activities in which they
may participate carry with them risks of harm that are particular to that activity,
such as, but not limited to the following:
Recreational and Workshop Activities
(a) being hit by swinging club, bat, racket or sporting utensil;
(b) death;
(c) being hit by a an object at speed
(d) strained muscle, ligaments or cartilages;
(e) broken or dislocated bones or joints;
(f) insect bites &/or animal / reptile bites;
(g) collision with persons or obstacles causing an injury;
(h) slipping / tripping and falling on undulating , wet or slippery surfaces;
(i0 foreign material or object entering eyes or skin irritations;
(j) injuries by flora or fauna;
(k) injuries caused by burns, cuts &/or abrasions;
(l) injuries caused by atmospheric conditions;
(m) injuries during travel to or from courses
(n) injuries caused by insecticides, fungicides and/or weedicides.
(o) injuries caused by poisonous substances
(p) injuries caused by fellow competitors, caddies and/or members of the public
(q)injuries caused by course machinery and or vehicles
(r) injuries caused by motor vehicles when crossing public roads.
(s) Illness/sickness caused by contaminated food
(t) pain and suffering resulting from any other activities conducted by the
NGA.
All details must be filled in and returned to the NGA Secretary
I authorise the Nepean Golf Association to arrange medical treatment and emergency
evacuation services on behalf of my child/ward and at my cost, in the event
of their injury or illness, as it deems necessary.
When participating in any of these activities, I will ensure that my child/ward
attends with the appropriate personal safety gear for the activity.
Club……………………………………………Grade………………………………………
Date………………………………………
Name of Parent or Legal Guardian…………………………………………………………...
Name Of Child……………………………………………………………………………....
Name of Program : Nepean Open Amateur, Nepean Foursomes Championship, Nepean
Presentation Dinner, Nepean Open Amateur and Nepean A, B, C or Mixed Pennants.
Phone No…………………………………………
Signature of Parent or Legal Guardian……………………………………………………….
Witnessed by :..........................................................................................................................
Signature:…………………………………………………………………
NGA WEBSITE
www.westsport.com.au
or
www.nepeangolf.org.au