SARATOGA JUNIOR GOLF, INC.               BRIAN RHODES

37 GREYLOCK DR.                                          DIRECTOR OF INSTRUCTION

GANSEVOORT, NY 12831                        

                           518-368-7473

                           www.saratogajuniorgolf.com

 

 


2007 PROGRAM REGISTRATION

Applicants Name_________________________________________

Applicants Age___

 

Home Phone #___________________

 

Parents Work #___________________

 

Parents Cell #____________________

 

E-Mail Address____________________________________

 

Parent or Guardians Name___________________________________

 

Applicants Medical Considerations (allergies, existing conditions, medications, etc..)

Please Describe_______________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

 

In consideration of the applicants participation in the Saratoga Junior Golf, Inc. clinics, camps, leagues and miscellaneous programs: 1.)  the applicant and the parent/guardian hereby release Saratoga Junior Golf, Inc., Airway Meadows Golf Course, and all of each companies respective officers, directors, employees, agents, subsidiaries and affiliates from any and all liability, damages, accidents, claims or injuries sustained by the applicant or parent/guardian in connection with these programs; 2.)  the applicant grants and assigns his/her individual media/photo rights respecting participation in these programs, without exception to the sponsors, Saratoga Junior Golf, Inc. and Airway Meadows Golf Course.

 

In case of a medical emergency during a Saratoga Junior Golf, Inc. program, I authorize a qualified, medical physician/professional to take all necessary measures in the treatment of this applicant.

 

 

Applicants Signature________________________________Date___________

 

Parent/Guardian Signature____________________________Date___________