Lehigh Valley Golf Pro

Student Information:

Student's Name:
Student's Age:
Address:
City:
State:
Zip:
Home Phone:
Daytime Phone:
Cell Phone:
Email:
Session:	July 25-28, 8:30 AM to 12:30 PM August 8-11, 8:30 AM to 12:30 PM
Own Clubs:	Yes, I will bring my own clubs No, I need clubs
If you need clubs:	Right handed Left handed
If applicable, name of sibling(s) also registering:
Comments:
IMPORTANT: Click the submit button only if you have read and understand this end-user agreement and agree to be bound by all of the terms and conditions of this agreement. If this agreement is not acceptable to you, please do not enroll in this program. I acknowledge the above information is correct and as the parent or legal guardian with full responsibility for the care of our child/custodial child listed above, in consideration for the opportunity for our child to participate in a program provided by Bethlehem Golf Club; and intending to be legally bound hereby, waive any and all rights of our child or myself, and releases Bethlehem Golf Club, and its employees and independent contractors relating to and from any and all claims or liability that may arise from any injuries or harm suffered by our child or myself caused by or occurring during our participation in the program. I grant permission for Bethlehem Golf Club, and its employees and independent contractors, to provide emergency care for us as Bethlehem Golf Club deems necessary. I shall directly, or indirectly through insurance coverage, assume financial responsibility for any medical charges incurred on behalf of care of our child or myself. I give Bethlehem Golf Club and its affiliates permission to use any photographic or video footage of our child or myself for marketing purposes.