2018 KJGA Membership Form
Please mail your Cashier check or Money order to: P.O. Box 1064, Lihue , HI 96766

You will receive an email confirmation once we receive your payment.

Membership is open to juniors between the ages of 5-18 years. Juniors interested must not have entered college or must not reach their 19th birthday on or before July 19, 2018

Jr. Golfer's First Name *
Your answer
Jr. Golfer's Last Name *
Your answer
Name of Siblings who are members
Your answer
Gender *
Birthday *
MM
/
DD
/
YYYY
H.S. Grad Year *
Your answer
Current School Attending *
Your answer
Collared Shirt Size *
GHIN Number *
If you do not currently have one please type N/A
Your answer
Year Joined KJGA *
Your answer
Home Golf Course
Your answer
Mother/Legal Guardian's Full Name *
Your answer
Mother/Legal Guardian's Phone Number *
Your answer
Father/Legal Guardian's Full Name *
Your answer
Father/Legal Guardian's Phone Number *
Your answer
Primary Contact *
Name and Phone Number
Your answer
Email *
Your answer
Secondary Email
If you would like to receive notifications to more than one email
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Emergency Contact: Name & Phone # *
Your answer
Total Amount Paying: 1st child: $60 & $30 for each additional child *
Your answer
I, as the parent or legal guardian, for the member and me, hereby release the Host Facilities, the Kauai Junior Golf Association (KJGA), its officers, directors and employees from any and all liability for any event or consequences whatsoever in any way arising out of or relating to member's participation in any KJGA event or activity with the sole and singular exception of liability arising out of bad faith or willful misconduct. In case of emergency during a KJGA event, I authorize a qualified physician to take necessary measures in the treatment of the KJGA participant. It is understood that neither the Host Facility nor KJGA is responsible for any loss of stolen items. Permission is hereby granted to the KJGA to use the members name and/or photo for promotional purposes. I, as the parent or legal guardian, by typing my full and legal name agree to all of the above. If you agree, type your full and legal name. *
Your answer
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