Junior Golf Registration Summer Junior Golf Registration Participant Information Child's Name Birthday Age Male/Female MaleFemale Shirt Size Shoe Size Parent Information Parent's Name Street Address City State/Province ZIP / Postal Code Home Phone Work/Cell Phone Email Address Emergency Contact (Other Than Parent) Emergency Contact's Name Emergency Phone Emergency Email Relation To Child Additional Information Registration Week June 3rd - 5thJune 10th - 12thJune 17th - 19thJune 24th -26thJuly 1st -3rdJuly 8th -10thJuly 15th -17thJuly 22nd -24th Does your child have any special needs (behavior or disabilities)? NoYes Identify Any & All Special Needs Does your child suffer from any life-threatening allergies? NoYes Identify Any & All Specific Allergies Does your child require any medications? NoYes List Any & All Medications Person(s) To Release The Child To: Person(s) NOT To Release The Child To: Δ
