Langley

Junior GT4K Program Registration Form

* Classes start March 1st

STUDENT INFO Student Name* Student Age/DOB* Boy/Girl* BoyGirl Current School* How much golf experience do you have? (example 0-1 yrs, 1-2 yrs)* Medical Conditions (list any allergies, medical conditions or medications we should be aware of)*

PARENT INFO Name(s)* Telephone Number* Email Address* Home Address* Emergency Contact/Relationship*

CONSENT AND WAIVER FORM
I consent to my child participating in lessons, practices, and events at the GreenTee Golf Academy.* YESNO I acknowledge that golf is a physical activity and assume all risks involved.* YESNO I authorize academy staff to seek emergency medical care if required.* YESNO
Date and Initial*

MEDIA RELEASE
I consent to promotional photos or videos of my child being used for GreenTee Academy purposes.* YESNO

CLASS SCHEDULE: GOLF 101 - ONCE PER WEEK / GOLF 201 - TWICE PER WEEK | EACH CLASS 1 HOUR
Class Preference: Choose 3
1st Choice* 2nd Choice* 3rd Choice*

Any further notes for the academy

SINATURE AND DATE
Signature*

Date*
*Required Field

GT4K Junior Program

Langley

Junior GT4K Program Registration Form

* Classes start March 1st