Medical Form

General Information

Junior’s Full Name

Hobbies & Interests

Fears or Phobias

Does your child have any faith or cultural needs?

Are there any circumstances, issues or personal/family issues that we should know about or that may affect your child while at Mypro?

If you’ve selected yes for any of the above, please specify:

Illnesses & Disabilities

If you’ve ticked any of the above, please provide full details here:

Allergies

Does your child have any food allergies?

Is your child allergic to any medication? (i.e. penicillin)

Any dietary requirement?

Does your child take any regular medication that they will be bringing to camp?

If you’ve selected yes for any of the above, please provide full details here:

Medication should be given to staff members on arrival. They are first aid trained. Please clearly mark the medication with name, dosage and with an English translation. Inhalers and epipens may be kept by the camper and spares may be given to camp staff. If any medication changes before the camp begins, please inform us of any changes.

Diseases

Please notify us if your child has come into contact with any contagious diseases in the two weeks preceding the camp.

If yes or others, please specify:

Has your child had any sports injuries that would affect their participation in the programme?

Does your child require any additional learning support or have any social, emotional or behavioural support needs?

If you’ve selected yes for any of the above, please provide full details here:

If your child wears glasses or contact lenses, we strongly advise that you provide them with a second pair in case they get lost or broken.

Person to contact in case of emergency

Contact’s Full Name

Relationship to junior

Mobile Number

Home Number

Doctor’s Details

Name of Family Doctor

Doctor’s Phone Number

If you would like to add the details of another person to contact, please give us those details here:

As parent/guardian of the named junior, I can confirm that the above named doctor has agreed that the student is in good health and fully able to participate in all activities of Mypro Golf Camp and I know of no restrictions, physical impairments or any other facts which would limit their participation. I hereby give my consent for my child to participate in all activities run by Mypro Golf and any associated suppliers. I have ensured my child’s willingness to participate in camp activities.

I confirm that the student is covered or will be covered with adequate medical and travel insurance to cover all medical care while at Mypro Golf Camp.

In the event of a medical emergency, I authorise Mypro Golf to grant permission for any health care required for the physical welfare of my son/daughter.

I declare that all the information is true and I have not withheld any relevant information.

Your Email Address

St Andrews Summer Golf Camp