Golf Camp Registration Form

Summer Golf Camp is now open for registration! Camp is offered to students ages 6-16. Students will receive full swing, chipping, putting and on course instruction. Camp session are held from 9:00am -12:00pm . Sessions are offered during the following weeks:

June 19-23
June 26-30
July 10-14
July 24-28
August 7-11
August 14-18

Camp fees are $300 for a full week (5 days of camp) or pro-rated daily rates are available at $65/day.

Camp will be limited to 24 students, with a 6:1 student/teacher ratio. Those who register after our class capacity has been reached will be placed on a waitlist.

Please note, if you are registering for more than one student, you will need to fill out this form seperately for each student.

Student Information

Which camp days are you registering for?*

June 19-23 (full 5 day week)-$302June 26-30 (full 5 day week) - $300July 10-14 (full 5 day week) - $300July 24-28 (full 5 day week) - $300August 7-11 (full 5 day week) - $300August 14-18 (full 5 day week) - $300Pro rated individual days - $65/day

If you are registering for pro-rated individual dates instead of a full camp week, please indicated which dates you are registering for:

Students Name*

First NameLast Name

Age*

Parent/Guardian Information

Name*

First NameLast Name

Home or Cell Number*

Area CodePhone Number

E-mail*

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.*

How did you hear about us?*

Release from Liabilities:

You assume your child may be at risk and danger incidental to the game of golf and the golf lesson and release the Golf Professionals, golf course, owners, employees and agents thereof from any and all liabilities resulting from such cases. Jacob Lusk (and other Golf Professionals) are running this camp at Camarillo Springs Golf Course.The golf course is not responsible for any liabilities arising out of this program nor does it know the details of the program. You do not pay the course but to the Professionals. The Golf Professionals are not responsible for children arriving early or picked up late

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature*

Clear

Clinic Registration Fee

June 19-23 - Full Week$300.00

June 26-30 - Full Week $300.00

July 10-14 - Full Week $300.00

July 24-28 - Full Week $300.00

August 7-11 - Full Week$300.00

August 14-18 - Full Week$300.00

Prorated rate for 4 individual days - $260.00

*Prorated rate for 3 individual days -$195.00

** Prorated rate for 2 individual days - $130.00

*** Prorated rate for 1 individual day - $65.00

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Summer 2023 Golf Camp Registration Form

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