Junior Name *

Age *

Date of Birth *

Gender MaleFemale

Grade *

Skill Level * BeginnerIntermediateAdvanced

Experience Level: i.e. has played before, never played before

Does the junior golfer have golf clubs? YesNo

Parent/Guardian Name(s) *

Phone Number *

Email *

Friends or Siblings wanting to be in the same group

Allergies/Medical Conditions to be aware of *

Secondary Emergency Contact Name *

Secondary Emergency Contact Phone Number *