Helping Youth Golf | Registration Form

Participants are required to complete and submit a registration/waiver form and pay a one-time $10 registration fee. All lessons and instructions are free. Upon registration, participants that do not have clubs are given a golf bag and a minimum of 3 clubs, appropriate for their height. Participants are given additional clubs as they progress in the program.

If your child/children are interested in learning the game of golf and would like to participate in our program, please email us at: Helpkidsgolf@yahoo.com and call 562-233-9429 for an immediate response to request additional information.

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Email *
Participant  First Name: *
Participant  Last Name:
 *
Date of Birth: 
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Age *
Height *
How did you hear about us? *
If other, where did you hear about our program? *
If you were referred by a current HYTG family, please list their name, or name of child, or Type N/A *
Hand form? *
Address  *
Phone *
Cell *
Emergency Phone: *
Name of Emergency Contact:
*
Relation of Emergency Contact to Participant: 
 *
Will golf clubs need to be provided for participant?
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LIABILITY WAIVER AND PERMISSION AGREEMENT By signing this agreement, I the participant(s) parent and/or guardian understand that participation in this activity may result in some type of injury and protective equipment does not prevent all injuries to participant(s). I hereby give permission for my child/children, ward(s), or myself to participate in the below registered program and/or activity and certify that my child/children, ward(s), (or myself) is physically fit to join in the activities. I hereby waive, release, and agree not to hold Help Youths Through Golf, supervisors, golf courses, and volunteers liable for any injuries that may occur as a result in participation of these activities, I also give my permission for any photos/videos, etc., of these activities taken during the program to be used for future program promotional materials. Please take note and govern yourself accordingly. Help Youths Through Golf does not have accident insurance to protect the participant(s). 

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