Name *
D.O.B *
Gender: * MaleFemale
Name
D.O.B
Gender: MaleFemale
Golf Experience * None1-2 Years3-4 Years5+ Years
Emergency Contact
Relationship to Participant *
Cell Phone *
Home/Work Phone
Camp/Clinic Name & Start Date
Consent
By signing below, I understand the risks inherent with this program. I do not hold liable Twin Willows Par 3 , Twin Willows Golf Academy or any of it’s representatives or employees. I will notify the proper individuals as to any risk factors and/or medical concerns that may affect participation in this program.
Print Participant’s Name *
Date *
