IGC Jr. Golf Camp Registration
Email address *
*
Hosted by: J.T Holsman , PGA

Camp Time: Tuesday-Friday 8:30am to 12:30pm

REGISTRATION FEES

Individual Camp $150 Each (Due before first day of camp) - family discount (2nd child and beyond $50 off)

Attend 2 Camps for $ 280

Attend 3 Camps for $ 400

(Multiple Camps must be paid completely at First Camp)

Optional $5 a day for lunch (hotdog-chips-beverage)

Pay by cash, credit card, or check payable to Ingleside Golf Club

Junior Golfer Information
Choose Camp(s): *
Required
Choose Camp(s): *
Required
Choose Camp(s): *
Required
Child's Name: *
Your answer
Gender: *
Age: *
Your answer
Birth Date: *
Your answer
Grade: *
Your answer
Address: *
Your answer
Phone *
Your answer
$5 Lunch? *
Parent/Guardian 1 Name: *
Your answer
EMAIL: *
Your answer
Parent/Guardian 1 Work Phone:
Your answer
Parent/Guardian 1 Cell Phone:
Your answer
Parent/Guardian 2 Name:
Your answer
Parent/Guardian 2 Work Phone:
Your answer
Parent/Guardian 2 Cell Phone:
Your answer
Emergency Contact Information
Emergency Contacts and persons authorized to pick up camper. In case of emergency, we will try to contact a parent first. In the event a parent cannot be reached, we need to be able to contact another friend/relative.
Emergency Contact 1 Name: *
Your answer
Relationship: *
Your answer
Work Or Cell Phone:
Your answer
Home Phone:
Your answer
Emergency Contact 2 Name:
Your answer
Relationship:
Your answer
Work Phone:
Your answer
Home Phone:
Your answer
Helpful Information
Has our child had golf instruction before? *
Required
Does your child have their own clubs? *
Required
Should there be any restrictions on your child's activities? *
Explain above if yes:
Your answer
Other sports the golfer participates in:
Your answer
Medical Information
List any Allergies (medication, animals, food, bee stings, other insects, Hayfever etc):
Your answer
Medications Taken Daily:
Your answer
Family Doctor *
Your answer
Family Doctor Phone: *
Your answer
Medical Insurance Company: *
Your answer
Medical Insurance Policy #: *
Your answer
Signature/Waiver
As the parent or legal guardian of a participant, I warrant and represent the participant has no disability, impairment or ailment preventing the above participant from engaging in active or passive exercise. This representation is made by myself as parent/legal guardian knowing that Ingleside Golf Club will rely upon it in allowing the above child to participate in the Golf Camp. I expressly agree their use of or attendance at Ingleside Golf Club is undertaken at my sole risk, and that the Ingleside Golf Club/Caln Township managers, and employees shall not be liable for any damages or injuries whether by negligence or not. Executors, administrators and assigns, do fully and forever waive, release and discharge Ingleside Golf Club/Caln Township managers, employees and agents from any and all claims, demands, damages, rights of action or causes of action resulting from or arising out of my/their use or intended use of the Ingleside Golf Club’s facilities and equipment. I understand that this assumption of risk and waiver also applies to Programs that may be held outside the facility and off Ingleside Golf Club grounds.
Signature: *
Your answer
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