Swan Lakes Junior Golf Registration Form

Participant's Name*

FirstLast

Parent/Guardian Name*

FirstLast

Email*

Address*

Street AddressCityZip Code

Primary Phone*

Cell Phone*

Participant's Age (As of June 1, 2012)*

Incase of Emergency Notify*

FirstLast

Emergency Phone*

Please Register My Junior Golf For:*

Junior Golf Clinic - $50.00
Monday Junior Club - $55.00
Wednesday Junior Club - $55.00
Junior Competitive League - $55.00
Junior Club Prepaid Green Fees (11 Weeks) - $75.00

Select All That Apply

Swan Lakes Junior Golf Clinics

Junior Golf Clinic Level*

Par (Level 1)
Birdie (Level 2)
Eagle (Level 3)

Par Level Clinics Dates/Times*

Birdie Level Clinics Dates*

June 25th - June 29th (8:00am)
July 9th - July 13th (8:00am)
July 23rd - July 27th (8:00am)
July 30th - Aug. 3rd (8:00am)

Eagle Level Clinics Dates:*

June 18th - June 22nd (8:00am)
July 16th - July 20th (8:00am)
Aug. 6th - Aug. 10th (8:00am)

Swan Lakes Junior Club

T-Shirt Size*

The Legal Stuff

1. I hereby recognize and acknowledge that participation in recreational activities may involve bodily injury or emotional injury to myself and/or my child. In consideration of my child being permitted to participate in such events, I hereby voluntarily and knowingly release, waive, and discharge Starkey Management Corp. D.B.A Swan Lakes Golf Course, its officers and employess from any and all liability that may result from my child’s participation in recreation activities. 2. I hereby authorize Swan Lakes Golf course staff to act on my behalf in accordance with their best judgment in case of an emergency, and agree to assume full responsibility for medical expenses that may arise therefrom.

I have read and agree to abide by Swan Lakes Parent/Participant agreement*