Buggy Request | nooQ Golf

Buggy Request Form

This form will be automatically sent by email to the Secretary when you submit the form.

A response will be sent to the email address you give below. We will respond as soon as we can.

Please familiarise yourself with the Buggy Transportation Policy before completing your application. The policy can be found by following this link – Buggy Transportation Policy

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 Captain Name

Club Captain Email

Statement of Truth

Signature *