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JUNIOR GOLF REGISTRATION
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JUNIOR CAMPS
GIRLS CLUB
INTRO CLINICS
PART A: Participant Information
Name
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Last
Address
*
Street Address
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Age
Birth Date
Month
Day
Year
Sex
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PART B: Family Information
Parent/ Guardian Name
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Last
Address
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Street Address
Address Line 2
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Phone
*
Email
*
Emergency Contact Name
*
First
Last
Emergency Contact Relationship
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Emergency Contact Phone
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PART C: Participant Medical & Special Needs Information
Severe Allergies
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PART D: Photograph Release & Waiver
Please select to complete registration
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I give my permission for The Royal Ashburn Golf Club to take photographs of my child during this program session for use in future promotional materials
I agree to release and save harmless The Royal Ashburn Golf Club, and its employee and other agents from any and all claims or other proceedings, regardless of who makes them, in respect of any damage or injury arising be reason participation in the program by myself or the person(s) who are shown as the “participant”.
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