LPGA-USGA Girls Golf Clinic at the USGA Girls' Junior Championship

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Come join us for a demonstration and hands on skill building clinic led by a talented group of LPGA Teaching Professionals on July 13th, 2012 at Lake Merced Country Club! We will be lucky enough to have a demonstration from several of the Championship Participants so the girls can really see how great some of these Nationally Ranked Juniors can hit the ball!

This complimentary clinic is for girls 7-17, we need everyone to arrive by 3:30pm to register and the clinic will begin PROMPTLY and run from 4:00-5:30pm on the driving range and practice facilities at one of the Bay Area's Premier Private Clubs in Daly City, CA.

We are limited to the first 100 girls that sign up and it is on a first come first served basis. ALL LEVELS OF GOLFERS ARE WELCOME!!

Participants Name *

Participants Age *

Address *

City *

State *

Zip *

Best Phone # for Emergencies *

Parent Email Address *

Parent/Guardian Name *

Golfing Experience *

Level I New Golfer Little or No Experience

Level II Able to play 125 yards from green

Level III Averages between 65-75 for nine holes on a regulation golf course

Level IV Averages between 55-64 for nine holes on a regulation golf course

Level V Plays 18 holes and scores 110 or better

Level VI Plays 18 holes and scores 95 or better

Release of Participant

Person(s) other than parent, who may pick up the participant at the end of any LPGA Junior Golf Clinics event

Name

Relationship to Participant

Phone Number

Consent and Release Form

Parent/Guardian Statement

I, the parent (or guardian) of the participant named above, am familiar with the plans and purposes of LPGA Junior Golf Clinics and give full permission for my son/daughter/ward to attend events and to participate in all phases of activities. I understand that, by signing this Consent & Release Form below, I agree to waive and release any rights and claims for damages against, and hold harmless LPGA. The LPGA Foundation, the USGA, LPGA Teaching and Club Professionals, The French Lick Resort, and all sponsors and other parties affiliated with the clinic or LPGA T&CP National Championship and each of their respective officers, directors, employees, volunteers, workers, members and agents ("Releases"), from and against any and all injuries or damages which may result from or arise out of my son's/daughter's/ward's participation in events and activities.

Medical Emergency Statement

I, the parent (or guardian) of the participant, (i) give my permission for my son/daughter/ward to receive emergency medical treatment; and (ii) agree to indemnify, waive, release, covenant not to sue, and forever discharge Releases for any and all liability or claims arising out of such treatment.

Agree

Yes

Photo and Press Release

I, being Parent/Guardian of the participant, hereby consent that any photographs and/or motion pictures or videotape in which he/she appears, and any audio recordings made of his/her voice may be used by LPGA Junior Golf Clinics, its assigns or successors, in whatever way they desire, including television and electronic media; furthermore, I hereby consent that such photographs, films, and recordings, and the plates and/or tapes, from which they are made shall be their property, and they shall have the right to sell, duplication, reproduce, and make other uses of such photographs, films, recordings, plates, and tapes as they desire free and clear or any claim whatsoever on my part.

Agree

yes

Clear selection

Parent/Guardian Signature

In Witness Whereof, I have read and understand this Participation Registration Form, agree to sign it willingly in my capacity as parent/guardian, and accept its terms and conditions

Digital Signature *

Submit

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