Junior Golf Program

Parent/Guardian Name*

First Last

Parent/Guardian Email*

Number of golfers to register*

Parent/Guardian Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Phone (preferred)*

Preferred contact number

Parent/Guardian Phone (secondary)

optional contact number

Golfer Information

Name (Golfer 1)*

First Last

Age (Golfer 1)*

Date of Birth (Golfer 1)*

Grade (Golfer 1)*

Gender (Golfer 1)*

Need Clubs (Golfer 1)*

Would this golfer like to borrow clubs from the Pro Shop?

No
Yes

Allergy/Medical Information (Golfer 1)*

** Please enter NONE, or specific details if there are any medical conditions that Western Turnpike should be aware of.

Golfer 1 program(s)*

Program – 1, Ages 10-17, July 1 - July 3, July 5 (NO THURS July 4), $120
Program – 2, Ages 10-17, July 9 – July 12, $120
Program – 3, Ages 10-17, July 16 – July 19, $120
Program – 4, Ages 10-17, July 23 – July 26, $120
Program – 5, Ages 7-9, July 30 – August 2, $120
Program – 6, Ages 10-17, August 6 – August 9, $120

Program – 1, Ages 10-17, July 1 - July 3, July 5 (NO THURS July 4), $120

Price:

Program – 2, Ages 10-17, July 9 – July 12, $120

Price:

Program – 3, Ages 10-17, July 16 – July 19, $120

Price:

Program – 4, Ages 10-17, July 23 – July 26, $120

Price:

Program – 5, Ages 7-9, July 30 – August 2, $120

Price:

Program – 6, Ages 10-17, August 6 – August 9, $120

Price:

Second Golfer Information

Name (Golfer 2)*

First Last

Age (Golfer 2)*

Date of Birth (Golfer 2)*

Grade (Golfer 2)*

Gender (Golfer 2)*

Need Clubs (Golfer 2)*

Would this golfer like to borrow clubs from the Pro Shop?

No
Yes

Allergy/Medical Information (Golfer 2)*

** Please enter NONE, or specific details if there are any medical conditions that Western Turnpike should be aware of.

Golfer 2 program(s)*

Program – 1, Ages 10-17, July 1 - July 3, July 5 (NO THURS July 4), $120
Program – 2, Ages 10-17, July 9 – July 12, $120
Program – 3, Ages 10-17, July 16 – July 19, $120
Program – 4, Ages 10-17, July 23 – July 26, $120
Program – 5, Ages 7-9, July 30 – August 2, $120
Program – 6, Ages 10-17, August 6 – August 9, $120

Program – 1, Ages 10-17, July 1 - July 3, July 5 (NO THURS July 4), $120

Price:

Program – 2, Ages 10-17, July 9 – July 12, $120

Price:

Program – 3, Ages 10-17, July 16 – July 19, $120

Price:

Program – 4, Ages 10-17, July 23 – July 26, $120

Price:

Program – 5, Ages 7-9, July 30 – August 2, $120

Price:

Program – 6, Ages 10-17, August 6 – August 9, $120

Price:

Third Golfer Information

Name (Golfer 3)*

First Last

Age (Golfer 3)*

Date of Birth (Golfer 3)*

Grade (Golfer 3)*

Gender (Golfer 3)*

Need Clubs (Golfer 3)*

Would this golfer like to borrow clubs from the Pro Shop?

No
Yes

Allergy/Medical Information (Golfer 3)*

** Please enter NONE, or specific details if there are any medical conditions that Western Turnpike should be aware of.

Golfer 3 program(s)*

Program – 1, Ages 10-17, July 1 - July 3, July 5 (NO THURS July 4), $120
Program – 2, Ages 10-17, July 9 – July 12, $120
Program – 3, Ages 10-17, July 16 – July 19, $120
Program – 4, Ages 10-17, July 23 – July 26, $120
Program – 5, Ages 7-9, July 30 – August 2, $120
Program – 6, Ages 10-17, August 6 – August 9, $120

Program – 1, Ages 10-17, July 1 - July 3, July 5 (NO THURS July 4), $120

Price:

Program – 2, Ages 10-17, July 9 – July 12, $120

Price:

Program – 3, Ages 10-17, July 16 – July 19, $120

Price:

Program – 4, Ages 10-17, July 23 – July 26, $120

Price:

Program – 5, Ages 7-9, July 30 – August 2, $120

Price:

Program – 6, Ages 10-17, August 6 – August 9, $120

Price:

Fourth Golfer Information

Name (Golfer 4)*

First Last

Age (Golfer 4)*

Date of Birth (Golfer 4)*

Grade (Golfer 4)*

Gender (Golfer 4)*

Need Clubs (Golfer 4)*

Would this golfer like to borrow clubs from the Pro Shop?

No
Yes

Allergy/Medical Information (Golfer 4)*

** Please enter NONE, or specific details if there are any medical conditions that Western Turnpike should be aware of.

Golfer 4 program(s)*

Program – 1, Ages 10-17, July 1 - July 3, July 5 (NO THURS July 4), $120
Program – 2, Ages 10-17, July 9 – July 12, $120
Program – 3, Ages 10-17, July 16 – July 19, $120
Program – 4, Ages 10-17, July 23 – July 26, $120
Program – 5, Ages 7-9, July 30 – August 2, $120
Program – 6, Ages 10-17, August 6 – August 9, $120

Program – 1, Ages 10-17, July 1 - July 3, July 5 (NO THURS July 4), $120

Price:

Program – 2, Ages 10-17, July 9 – July 12, $120

Price:

Program – 3, Ages 10-17, July 16 – July 19, $120

Price:

Program – 4, Ages 10-17, July 23 – July 26, $120

Price:

Program – 5, Ages 7-9, July 30 – August 2, $120

Price:

Program – 6, Ages 10-17, August 6 – August 9, $120

Price:

Check Out

Waiver*

WAIVER OF PARTICIPANT OF SELF: In consideration of your accepting my or my child’s registration and entry, I hereby for myself, my child, my heirs, executors and administrators, waive and release any and all rights and claims for damages I or my child may have against the Western Turnpike Golf Course and its representatives, successors and assigns for any and all injuries suffered by myself or my child at any activity sponsored by these groups. I understand there is an inherent risk of injuries associated with the activity and authorize emergency medical treatment and transportation in my absence. I give my permission to the Western Turnpike Golf Course to use pictures of my child taken at Program activities. I understand that the Director has the right to withdraw any junior golfer who is disruptive in the program, and no refund shall be given. By checking the "I Accept the Agreement" box and continuing to check out, I assert that I have read the waiver and understand and agree to all the terms stated.

I Accept the Agreement

Total

$0.00

NOTE: You must select a valid program for at least one junior golfer before an amount is displayed in "Total" and the "Check Out" button is displayed.

Comments

This field is for validation purposes and should be left unchanged.

Junior Golf Registration

Golfer Information

Second Golfer Information

Third Golfer Information

Fourth Golfer Information

Check Out