Saturday May 19
Junior Golf Form
  1. Participant's Name
  2. Date of Birth
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  3. Mail Address
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  4. City
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  5. State
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  6. Zip
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  7. Home Phone
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  8. Parent Work Phone
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  9. Parent Email(*)
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  10. Doctors Name
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  11. Doctors Phone
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  12. Emergency Contact Name
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  13. Emergency Contact Phone
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  14. Does your child have their own clubs?
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  15. Height (inches)(*)
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  16. Childs dominate hand(*)
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  17. Select the program that you are interested in.

  18. Boy's age 9-17: $20.00 Fee * Monday-Thursday
  19. Boy's Beginner
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  20. Boy's Intermediate
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  21. Girl's age 9-17: $20.00 Fee * Monday-Thursday
  22. Girl's Beginner
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  23. Girl's Intermediate
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  24. Girl's and Boy's Ages 6-8: * No Fee! Parent or Guardian must attend with child!
  25. Choose Class
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  26. In an emergency, if the instructor or Estes Valley Recreation & Parks District is unable to reach you, do we hereby have your permission to take appropriate action, including admission to a hospital, as in our opinion the situation demands?
  27. I agree(*)
    Please submit your agreement answer!
  28. Please type the following text
    Please type the following text
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  30. Total
    0.00 USD
  31. I hereby assume full responsibility in case of injury, accident, damage or loss of any nature whatsoever to the above named child or his/her property during the course of the above named youth program, and hereby release and agree to hold harmless the Estes Valley Recreation & Park District, its supervisors and its volunteer staff.