Buggy Request | Cumbria Union of Golf Clubs

Buggy Request Form

The use of a buggy is a reasonable adjustment for a disability within the meaning of the Equality Act 2010.

Player Details

First Name *

Surname *

Club *

Email *

Phone *

Impairment Assessment

Do you have a physical or mental impairment within the meaning of the Equality Act 2010? *

Does that impairment have a substantial adverse effect on your ability to carry out day to day tasks? *

Does that impairment have a substantial adverse effect on your ability to walk long distances, carry golf clubs, or otherwise play a round of golf? *

Is the impairment Permanent or Temporary? (It is Permanent if it has lasted/will last more than 12 months) *

Brief Description of Impairment

Note: You may be asked to provide supporting evidence or documentation. If you have any medical documentation available, please have it ready to submit if requested.

Club Verification

Please provide the name and email of your Club Captain or other club official who can verify this request if necessary.

Club Contact Name

Club Contact Email

Statement of Truth

Signature *