Players Name   Phone Email

Address City   Zip

Date of Birth Age as of April 1, 2010        Boy or Girl

Golf Handicap or Average 18 Hole Score   

7-11 Year Old Flights: Average  9 Hole Score

As parent or guardian of the applicant, I hereby certify the facts in this entry form and state that I  am familiar with applicant’s plans to participate; that he/she does so with my approval. And that we have read and understand the tournament rules and regulations and agree to abide by same. Further, I, for myself and the applicant, hereby release and hold harmless the Committee, Officials, Donors, Golf Clubs/Courses, JGANC, FGSJVJGF, their officers and directors, from any and all liability for any event or consequence whatsoever in any way arising out of or relating to the applicant’s entry or participation in the tournament.

Your registration for this event will constitute your acceptance and agreement to this release and hold harmless agreement. We reserve the right to require submission of an original signature of the parent/guardian in a confirmation copy of the on line Registration.

Spectators including parents must not converse, advise, coach, or hinder any player’s game and stay at least 25 yards from players at sides of fairways; stay off greens: no radios or cell phones on course; authorized cameras only.

     The applicant junior and parent/guardian have read, understand and will comply with the PARENT/ PLAYER LETTER.

Emergency Contact Telephone Number 

Date   Name of Parent/Guardian