Pay with Check - Participant Signup

Participant #1 Name *
Participant #1 Name
Participant #1 Birthdate *
Participant #1 Birthdate
Participant #2 Name (If applicable)
Participant #2 Name (If applicable)
Participant #2 Birthdate (If applicable)
Participant #2 Birthdate (If applicable)
Parent/Legal Guardian Name *
Parent/Legal Guardian Name
Phone *
Phone
Participant Address *
Participant Address
Participant #1 Location Preference *
Please specify day, time, and golf course
Participant #2 Location Preference (If applicable)
Please specify day, time, and golf course
Media Release *
I hereby give Gator Junior Golf Association and participating agencies permission to use film, video tape, and/or photographs of the below mentioned minor for lawful promotional or informational purposes.
I, the parent/legal guardian of the above named youth, give approval for participation in Gator Junior Golf Association’s sponsored activities. I understand that Gator Junior Golf Association is an independent organization which benefits from the participation of many golf organizations including the Amateur Athletic Union and its oversight organizations. I assume all risks of injury whatsoever and agree to hold harmless Gator Junior Golf Association including Amateur Athletic Union and its oversight organizations from claim(s) of any nature arising from any activity, including transportation, connected with Gator Junior Golf Association’s facility or program(s). This hold harmless agreement includes, but is not limited to, any claim due to injury resulting from negligence of Gator Junior Golf Association and its oversight organizations, participating agencies, and volunteers. I consent to Gator Junior Golf Association and its oversight organizations to communicating information regarding my child’s participation via the internet.