2022_LJGDC_Registration

Family Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Home Phone

Mother's Name

First Name Last Name

Mother's Work Phone

Area Code Phone Number

Mother's Cell Phone

Area Code Phone Number

Mother's Email

Father's Name

First Name Last Name

Father's Work Phone

Area Code Phone Number

Father's Cell Phone

Area Code Phone Number

Father's Email

Child #1 Name *

Child #1 Shirt Size *

Child #1 Gender *

Male Female

Child #1 Birthdate *

Month Day Year

Child #1 - enter the program(s) attending with dates & time frame (eg. Learn to Golf Wednesdays May to Sept AND Junior League *

Child #2 Name

Child #2 Shirt Size

Child #2 Gender

Male Female

Child #2 Birthdate

Month Day Year

Child #2 - enter the program(s) attending with dates & time frame (eg. Golf Camp - week of July 22 - 26)

Child #3 Name

Child #3 Shirt Size

Child #3 Gender

Male Female

Child #3 Birthdate

Month Day Year

Child #3 - enter the program(s) attending with dates & time frame

Waiver and Release:

I give permission to the London Junior Golf Development Centre and BG Golf to photograph and/or record myself, my junior and/or the voice of myself or junior on still photographs, motion picture film, audio tape and/or video tape and to use this material, in whole or in part, through the media of television, film, internet, multi-media presentation, radio, audiotape, videotape or in printed form or display form for the promotion of the London Junior Golf Development Centre and BG Golf. I assign and transfer to London Junior Golf Development Centre and to BG Golf any and all rights, including copyright, which I may have in the material.

I do hereby release the London Junior Golf Development Centre, BG Golf, it’s Officers, Directors, Employees, Volunteers and Independent Contractors from all liability, claim causes of action of any kind whatsoever in respect to all personal injuries, loss of life or property losses, which I or my junior may suffer out of the activities of the London Junior Golf Development Centre and BG Golf.

NOTE: By entering your name in the boxes below, you agree to the terms of the waiver and release.

Parent #1 Signature *

First Name Last Name

Parent #2 Signature

First Name Last Name

REMINDERS:

Ensure you select the Seasonal registration fee quantity for the number of juniors registering.

SOLD OUT PROGRAMS:

Spring - Learn to Golf Thursday nights

Spring - Active Start

Summer - Active Start

My Products

Seasonal Registration Fee $ 40.00 CAD

Quantity

Future Player Program - includes seasonal registration (NOTE: 5 additional monthly fees required) $ 375.00 CAD

Quantity Select Day of Week

Active Start - SPRING season *SOLD OUT* $ 97.00 CAD

Quantity

Active Start - SUMMER season *SOLD OUT* $ 97.00 CAD

Quantity

Learn to Golf - SPRING SEASON $ 237.00 CAD

Quantity Select Day of Week

Learn to Golf - SUMMER SESSION $ 237.00 CAD

Quantity Select Day of Week

Learn to Golf - FALL SESSION $ 237.00 CAD

Quantity Select Day of Week

Summer Golf Camp - HALF DAY $ 225.00 CAD

Quantity Select Week

Summer Golf Camp - FULL Day 5 DAYS $ 375.00 CAD

Quantity Select Week

Subtotal $ 0.00 CAD Tax $ 0.00 CAD Total $ 0.00 CAD

Credit Card

2022 Junior Golf Registration Package

Credit Card