Junior/Learn to Play Registration Form

PETITCODIAC VALLEY GOLF AND COUNTRY CLUB

Junior /Learn to Play  Registration Form

 Golfer Name: _____________________________________

Contact Information:

          Home Phone:______________________________

          Cell Phone: ________________________________

          Mailing Address: ____________________________

          __________________________________________

Current Age: ____________If under 6, must be accompanied by parent or guardian.

Date of Birth: _____________

Parent Name: ___________________________________________

Parent Contact Information: _______________________________

          Cell Phone:_________________________________________

Parent Email: ___________________________________________

Golf History:

          Do you golf Left handed ___________or Right____________

          Do you have own clubs?        Yes     or           No

          What would you consider your skill level?

          Beginner (no experience)________

          1-2 years’ experience____________

3-4 years’ experience ________________

Over ________________________

Payment made at time of registration:         Yes     or No

***Please attach receipt to form.***