Full Name

Date of Birth

Home Address

Home Phone No.

Name of Parent/Guardian (1)

Work Phone (Parent/Guardian 1)

Mobile Phone (Parent/Guardian 1)

Email Address (Parent/Guardian 1)

Name of Parent/Guardian (2)

Work Phone (Parent/Guardian 2)

Mobile Phone (Parent/Guardian 2)

Email Address (Parent/Guardian 2)

School/College

Present Golf Club and Handicap (if applicable)

The Proposer and Seconder must be Full Member of Mullingar Golf Club. A member of the Committee of Management, the Men's Committee or the Ladies Committee may not propose or second a candidate.

Name of Proposer:
Date
Signature of Proposer:

Note: A Junior Member shall be between 8 and 17 years of age on the 1st January 2024. Junior Members will be on probation from the date of acceptance until the age of 18.

Mullingar Golf Club will adhere to "Code of Ethics for Golf for Young People". You can download a copy of this on the Mullingar Golf Club website. Juniors may not introduce guests to the Club.

DECLARATION TO BE SIGNED BY APPLICANT

I agree to be bound by rules as set out for junior golfers by the Management Committee of Mullingar Golf Club.

Signature of Junior Applicant:

A copy of Passport/Birth Certificate must be submitted with application to verify date of birth.

Upload Passport or Birth Certificate

The safety and welfare of junior members, when in our care, is paramount, and it is therefore important that we are
aware of any illness, medical condition and other relevant health details so that their best interests are addressed.

MEDICAL INFORMATION

Child's Doctor's Name (Optional)

Surgery Address (Optional)

Surgery Telephone Number (Optional)

Medical History Information
Please include all medical details that might be relevant in dealing with your child in a safe manner, such as
allergies, medication, special requirements etc.

Parental / Guardian Consent
a. I consent to the above child participating in golf activities at Mullingar Golf Club in line with the Club’s Code of Ethics for Golf for Young People and the Club’s Regulations for junior members.
b. I will inform the club of any changes to the information provided above. I confirm that all the details are correct, and I am able to give parental consent for my child to participate in and travel to all activities.
c. I understand that photographs will be taken during or at golf related events and may be used in the promotion of golf. By agreeing to your images being used, you agree to assign any copyright or any other right of ownership of these images to the Club.
d. I acknowledge that the club is not responsible for providing adult supervision for my child except at formal events and junior golf coaching, matches or competitions.
e. Overnight Away Trips - If selected for representative teams, I confirm I am happy with the travel and accommodation arrangements the Golf Club may arrange for my child.
f. The club has a Data Privacy Policy which can be found in the Club Document folder of our Club V1 membership app. Your data will be stored and used in accordance with this policy.

Incomplete applications will not be accepted.

Signature of Parent/Guardian:

Printed Name

Date

Submit your application