Make checks payable to Gig Harbor Golf Club Junior Program.

Registration fee includes a half sleeve pullover, golf instruction, practice balls and supervised golf course play. Also included will be an end-of-season tournament and awards banquet.

PLEASE FILL IN ALL AREAS OF THIS REGISTRATION FORM AND MAIL WITH CHECK TO GIG HARBOR GOLF CLUB, C/O JUNIOR GOLF, 6909 ARTONDALE DR NW, WA 98335.

Junior Golfer Sex Birth Date

Address City State Zip Code

Parent Name home phone work phone e-mail address

Has Junior Golfer been in the Gig Harbor Junior Golf Program in the past? _________________________

If YES…When ______________What Level______________Average score________ Handicap________

If NO…What experience does Junior Golfer have? ___________________________________________________

Has he/she had any lessons? _____________How many rounds of golf have Junior Golfer played on a golf course? ________Average score for 9 holes? __________.

Junior Golfer must provide his/her own bag and clubs (no sharing). Contact Pro Shop if you need help finding junior clubs or a bag.

Is Parent a member of GHGC (circle one) YES NO Name_______________________________

Is Grandparent a member of GHGC (circle one) YES NO Name_______________________________

Phone#(_____)______________e-mail____________________________________________

If not a member, how did you hear about our program?_________________________________________________

_____________________________________________________________________________________________

I for myself and the applicant hereby release the GHGC employees and it’s volunteers from any and all liability for any event of consequence whatsoever arising out of or relating to the applicant’s participation in the Gig Harbor Jr. Golf activities and tournaments. While participating in the Gig Harbor Junior Golf Program, my child is in the care of the volunteer adults. If a medical emergency should arise, those in charge have my permission to seek medical attention from a qualified medical doctor.

Doctor’s Name____________________________________________ Phone(_____)_____________________

I acknowledge that if my child/grandchild displays improper conduct and shows no ability to take direction, he/she may be disqualified from the next session(s) or from the remainder of the program.

Parent Signature____________________________________________

Date_________________________

FOR OFFICE USE ONLY

Payment received____/____/____ Check amount$__________Check #__________ Received by________________

REGISTRATION DEADLINE IS JUNE 10, 2005

MEMBERS: 50.00

Make checks payable to Gig Harbor Golf Club Junior Program.

PLEASE FILL IN ALL AREAS OF THIS REGISTRATION FORM AND MAIL WITH CHECK TO GIG HARBOR GOLF CLUB, C/O JUNIOR GOLF, 6909 ARTONDALE DR NW, WA 98335.

FOR OFFICE USE ONLY

Golfer_________________________________________________Level_____________Scheduled Time_____________

Golfer___________________________________________Level_Scheduled Time_______