Tell me a little bit about yourself: *Required field

*Name
*Date of Birth                     *Age (if Jr.)
Grade:     Name of School:
Height (if clubs are needed:
Parent's Names
*Contact  Phone
*E-mail

Select any of the following options that apply:

I need clubs for the clinic     I play right handed   I play left handed

Choose the Program & Date Attending (if the class you would like to take does not appear on the drop down list, all available spots have been filled)

Parent Waiver & Release  Participation in all sports and physical activities involves certain inherent risks and, regardless of the care taken, it is impossible to ensure the safety of the participants.  While junior development camp is a reasonably safe activity as long as safety guidelines are followed, some elements of risk cannot be eliminated from the activity.   A variety of injuries may occur during camp.  Some examples of those injuries are:  minor injuries such as muscle strains, sprains, and muscle soreness;   more serious injuries such as damaged ligaments, broken bones, and concussions;  catastrophic injuries such as heart attacks, paralysis, and death. To help reduce the likelihood of injury to yourself and to others, participants are expected to follow the following rules.  All participants are expected to:  follow the instructions of the leaders/golf professionals,  wear proper clothing and footwear,  follow all posted safety rules. I agree to follow the preceding safety rules, all posted safety rules, and all rules common to the activities during camp.  Further, I agree to report any unsafe practices, conditions, or equipment to the leaders/golf professionals.

I certify that:* (Junior's Name) possess a sufficient degree of physical fitness to safely participate in junior development camp.    I understand that I am to discontinue activity at any time I feel undue discomfort or stress.  I will indicate any health-related conditions that might affect my ability to participate in junior development camp and I will verbally inform the leaders/golf professionals immediately. I have read the preceding information and it has been explained to me.  As a parent I understand, and appreciate the risk associated with participation in junior development camp and I am voluntarily participating in the activity.  In doing so, I am assuming all of the inherent risk of the activity.  I further understand that in the event of a medical emergency, the leaders/golf professionals will contact EMS to render assistance and that I will be financially responsible for any expenses involved.  WAIVER of LIABILITY:  In consideration of my child(ren) being permitted to participate in this camp, on behalf of myself, my family, my heirs, and my assigns, I hereby release BlackHorse Golf Club, and it’s employees from liability from injury, loss or death to myself, while taking part in this camp, resulting from the ordinary negligence of BlackHorse, it’s agents or employees. I hereby give REDSTONE GOLF MANAGEMENT, BlackHorse Golf Club and the BlackHorse Golf Club Teaching Center the unqualified right to take pictures of me and my child and to use the finished pictures for marketing purposes, including, but not limited to promotional brochures, direct mail, catalogues, advertisements and/or websites.

I AGREE TO THE PARENT WAIVER/RELEASE