St Bridgets Pitch & Putt

Juvenile Membership Form 2024

Your Online Payment Order Number
Before completing this application form please CLICK ON THE MEMBERSHIP BUTTON ON HOMEPAGE and pay the appropriate membership fee online. Once done please make a note of your order number/details and add that number to this field. This will help us reconcile application forms against payments. Many thanks.
Child's Full Name(Required)
Please enter Christian and Surname
Childs existing PPI Registration number if previously a member

Please note: This will be the regisitration number on your previous years membership card. This is important so please add if possible as it speeds up the registration process.
Date of Birth of Child(Required)
Male/Female(Required)
Please select from the drop down menu.
Full Address including Eircode(Required)
Please enter your full home address including Eircode.
Parent/Guardian Name(Required)
Parent/Guardian Mobile Phone Number(Required)
Parent/Guardian Email Address(Required)
Please enter s valid email address
GP Name(Required)
Please input the name of your doctor
GP Contact Number(Required)
Details of any known medical condition or allergies(Required)
Please input any medical conditions or allergies your child may have. This information is strictly confidential.
Photography consent
- YES
- NO
From time to time we will use pictures to help promote the club and to post on our social media channels. Do you give consent for photos to be used. Please check appropriate box below.
My Child is in good health but I understand that it is my duty to advise the Pitch and Putt Club of any changes. In the event of illness, having parental/ (legal) guardian 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 authorize medical practitioner to provide emergency treatment or medication. I hereby consent to the above child participating in the Pitch and Putt activities of the P&P Club in line with the Code of Ethics for Young People. I confirm that all details are correct, and I am able to give parental/ (legal) guardian consent for my child to participate in any matches or Pitch and Putt event organised by the above Club and any other affiliated Club and to be on any Pitch and Putt Premises (Clubhouse, Course and Practice Areas). I acknowledge however with this, that both the Club and others do not have responsibility for providing adult supervision for my child except for Formal Coaching and Competitions. I further consent to my child: Playing with older children/adults in County, Regional or National events Subject to my prior approval (which will be deemed to have been given in the absence of contact with the Official in charge) travelling in the company of an Adult or Adults to an event in which the Club or county is playing as a Team or Individually Receiving outdoor or indoor coaching or any other instruction from any Club Coach, County Coach or National Coach Receiving instruction and advice from any Club or County Officer, Club, County or National Official or any other authorised Representative Receiving such advice and instruction as may be considered to be reasonable in the circumstances from Club, County or National Officer to protect the interests of my Child whilst they are properly involved in any event organised by the Club, County or National body in part or the whole 6. Being included in any Team or Group photographs, or being the subject of Coaching and Instruction by Video Photographs I understand that photographs may be taken during or at sport related events and may be used in the promotion of the sport. 401
Parent/Guardian check box if all above are correct and rules and regulations are understood
- I Agree
By submitting your application and once verified and payment is received you agree to abide by the rules and regulations of St. Bridget's Pitch & Putt Club and the consitution of Pitch & Putt Ireland. PLEASE NOTE YOUR APPLICATION IS SUBJECT TO VERIFICATION BY COMMITTEE AND MAY BE REFUSED. ANY REFUSED APPLICATION WILL HAVE FEE REFUNDED. PLEASE ALLOW UP TO 14 DAYS FOR A REFUNDED FEE TO SETTLE.
Child check box if all above are correct and rules and regulations are understood
- I Agree
Email
This field is for validation purposes and should be left unchanged.