Clonakilty Tennis Club

* Your name (payer)

* Your email (for receipt)

* Your mobile number

* Address

* Child 1: First Name

* Child 1: Last Name

* Child 1: DOB

Child 1: GenderMaleFemale

* Child 1: Please indicate whether this person has allergies, conditions or medication requirements, which may impact their health, welfare, learning or behaviour while participating in our activities. If answering Yes, then please remember to provide the coach with more details before this member participates in activities.

Child 1: Level of Tennis Experience (if known):

* Child 2: First Name

* Child 2: Last Name

* Child 2: DOB

Child 2: GenderMaleFemale

* Child 2: Please indicate whether this person has allergies, conditions or medication requirements, which may impact their health, welfare, learning or behaviour while participating in our activities. If answering Yes, then please remember to provide the coach with more details before this member participates in activities.

Child 2: Level of Tennis Experience (if known):

* Child 3: First Name

* Child 3: Last Name

* Child 3: DOB

Child 3: GenderMaleFemale

* Child 3: Please indicate whether this person has allergies, conditions or medication requirements, which may impact their health, welfare, learning or behaviour while participating in our activities. If answering Yes, then please remember to provide the coach with more details before this member participates in activities.

Child 3: Level of Tennis Experience (if known):

* Emergency Contact Name (if you cannot be contacted)

* Emergency Contact Number (if you cannot be contacted)

* I am aware that my Children's photograph or video image may be taken whilst attending or participating in games or activities connected with the Club and I consent to it being used by the Club for items like match programmes, year books, match reports, event reports or on the Club website or social media channels.

* In the event of illness, having parental responsibility, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitably qualified medical practitioners. If I cannot be contacted and my child needs emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency treatment or medication.

* I/We consent to the above child(ren) participating in activities of the organisation in line with the Sport Ireland’s Safeguarding Guidance for Children and Young People in Sport.

* I/We consent to allow my child(ren) to walk home after session is finished.

Clonakilty Tennis Club

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