Please fill out each item on this sheet.
Name of junior member
Email (where tee times will be sent)
Address (House number, Street, City, State, and Zip)
Phone number (xxx-xxx-xxxx)
Child's Date of birth (mm/dd/yyyy)
Emergency contact phone number (xxx-xxx-xxxx)
Grade in 2018 - 2019
Freshman (9th grade)
Sophomore (10th grade)
Junior (11th grade)
Senior (12th grade)
Please check all of the tournaments that you will be playing in. Signing up for all 10 will earn you a sleeve of Titleist golf balls and a Bump and Run golf towel. Not sure? Sign up and pay for the first tournament, pay the membership fee and then sign up for tournaments as you go. You may register for tournaments up to a week prior to the tournament start date.
Willow Hollow Golf Course ($30)
Rich Maiden Golf Club ($30)
Berkshire Country Club ($30)
Manor Golf Course ($30)
Putting clinic at Manor (beginner $30)
Putting clinic at Manor (intermediate/advanced $30)
Chapel Hill ($30)
Berkleigh Golf Club ($30)
Reading Country Club ($30)
Flying Hills Golf Course ($30)
Blackwood Golf Course ($30)
Fox Chase ($30)
The following must be read and signed by the applicant and parent or guardian. The undersigned/individual and the parent or legal guardian ask that by permission of the 2018 Bump and Run Junior Golf tour (B&R) and the related tournaments and events as listed on the B&R schedule, do hereby agree to release, discharge, and hold harmless that B&R, its officers, employees and tournament sponsors from all liability, claims or demands whatsoever from damages on account of any accidental incident involving the said minor; arising from, or in the course of activities and competition in any 2018 B&R event. All tournament participants understand and agree that all tournament committee membership and tournament entrance decisions; and tournament rulings and results are final. By clicking agree and typing your first and last name below you agree to these terms.
Parent or Guardian
I hereby grant Bump and Run Junior Golf permission to use my child's likeness in a photograph, video, or other digital media ("photo") in any and all of its publications, including web-based publications without payment or other consideration. By clicking agree and typing your first and last name you agree to these terms.
Do not give permission
Parent or Guardian Signature
Refer a friend? (To be eligible for the refer a friend prize, your referral must purchase a membership and sign up for at least one tournament. You will receive a free sleeve of Titleist Pro V1 golf balls)
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