Under 18's Private Lesson Travel and Medical Condition Disclosure

Name of Participant*
First Last
Date of Birth*
MM slash DD slash YYYY
Gender*
School of Participant*
- Primary School
- High School
Name of School*
What year is the participant in?*
Does the participant have any medical conditions or allergies which may impact participation in these programs?*
- Yes
- No
Please specify these medical conditions or allergies.
Does the participant require any medication to treat this condition?*
- Yes
- No
Agreement Regarding Medication*
- I acknowledge that it is my duty to ensure that the participant will bring this medication with them to the Club.
Does the participant have an ASCIA Action Plan that has been created for the treatment of this allergy or medical condition?*
- Yes
- No
Please attach Action Plan to this enrolment form.
Max. file size: 6 MB.
Permission for use of Medication*
- I give permission for Royal Sydney staff to assist with administering medication in the event that it is needed in line with the ASCIA Action Plan instructions below.

Member Name*
First Last
Member Number*
Member's Relationship to Participant*
Member Phone Number*
Member Email*
Is the above person the primary contact?*
The primary contact will be contacted regarding any weather cancellations or in case of emergency.
- Yes
- No
Primary Contact Name*
First Last
Primary Contact's Relationship to Child*
Primary Contact Phone Number*
Primary Contact Email*

Arrival/Departure
- If the participant is in Primary School they must be walked to the Tennis Court and signed in at the commencement of their private tennis lesson by a guardian aged 16 years or over.
- If the High School is in High School they may attend the lesson without a guardian and may sign themselves into the private tennis lesson
Authorisation for drop-off or pick-up by someone who is not the Primary Contact listed (optional)
Nominated guardians must be at least 16 years old.
- I give permission for the following people to be authorised to pick up/drop off my child.
I give permission for the following people to be authorised to pick up/drop off my child*
First Name Last Name Relationship to Child
Permissions
- I give permission for my child to make their own way to and from the Club.
- I consent for my child to attend the Club on their own. I ackowledge they will only be supervised during lessons or Club functions
Please specify the way your child will be accessing the Club if they are not being dropped off and picked up from the Golf Concourse or Tennis Pavilion. E.g. pick up outside Reception, catching a bus, riding a bike, walking.*
Method of Drop-Off Method of Pick Up

Terms and Conditions*
- Select All
- I give permission and consent for photos/videos of the participant to be taken by Royal Sydney and used solely for internal use or technical correction and in accordance with the Royal Sydney Privacy Policy available at rsgc.com.au

Under 18’s Private Lesson Travel and Medical Condition Disclosure

First Name	Last Name	Relationship to Child