Hawks Landing GOLF Academy

REGISTRATION FORM

(Please Print) Paid: Y / N Card type: Check number: Amount:
Today’s date:	Hawk’s employee initial:
PLAYER INFORMATION
Player’s last name:	First:	Middle:	Grade:
Birth date:	Age:	Gender:
/ /	M	F
Street Address:
City:	State:	ZIP Code:
How did you hear about us? Mark below
Family	Friend	Close to home/work	Online	Other	Tell us:
Select one or more: Week 1: July 5-8 10:00am-2:00pm Week 2: July 11-14 10:00am-2:00pm Week 3: July 18-21 10:00am-2:00pm Week 4 July: 25-28 10:00am-2:00pm
IN CASE OF EMERGENCY
Parent Name Phone email
Name of local friend or relative (not living at same address):	Relationship to player:	Home phone no.:	Work phone no.:
( )	( )
I/We the parents/guardians of the above-named candidate for a position in a golf academy, hereby give my/our approval to participate in any and all golf activities. I/We know that participation in golf may result in serious injuries, and do hereby waive, release, absolve, indemnity, and agree to hold harmless the local golf academy.
Patient/Guardian signature	Date