Summer Junior Golf Registration Participant InformationChild's Name *Birthday *Age *Male/Female *Please select an optionMaleFemaleShirt Size *Shoe Size *Parent InformationParent's Name *Street Address *City *State/Province *ZIP / Postal Code *Home PhoneWork/Cell PhoneEmail Address *Emergency Contact (Other Than Parent)Emergency Contact's NameEmergency PhoneEmergency EmailRelation To ChildAdditional InformationRegistration Week *Please select an optionJUNE 3RD – 5THJUNE 10TH – 12THJUNE 17TH – 19THJUNE 24TH – 26THJULY 1ST – 3RDJULY 8TH – 10THJULY 15TH – 17THJULY 22ND – 24THDoes your child have any special needs (behavior or disabilities)? *Please select an optionYesNoIdentify Any & All Special Needs 0 / 50Does your child suffer from any life-threatening allergies? *Please select an optionYesNoIdentify Any & All Specific Allergies 0 / 50Does your child require any medications? *Please select an optionYesNoList Any & All Medications 0 / 50Person(s) To Release The Child To: 0 / 50Person(s) NOT To Release The Child To 0 / 50Send Message Contact (713) 526-0077 mdotch@bslgolf.com Location 2155 N. MacGregor Way Houston, TX 77030
