2026 Junior Golf Clinic
*Must register by May 31st. We will not be having online payment for this program. Payments can be made by cash or check to "Page County Recreation Department." Payments may be mailed or dropped off at "Attn: Recreation Department. 103 South Court Street. Luray, Va. 22835." Registration Fee for this program is $50. We will also accept payment the day of the clinic. We will email everyone as we get closer with more details.
Youth's Name
*
First Name
Last Name
Sex
*
Male
Female
Other
Height
*
Age (Ages 8-16)
*
Grade
*
Club Style
*
Right Handed
Left Handed
Does the participant have clubs?
*
Yes
No
Parent/Guardian Contact
*
First Name
Last Name
Email
*
example@example.com
Phone Number (Cell preferred)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Phone Number (Optional)
Please enter a valid phone number.
Format: (000) 000-0000.
Back
Next
Waiver and Release of Liability
By agreeing to the terms & conditions below, you agree to the Player & Parent Agreement Statement as follows. "I, the participant, or my child named above agree to participate in the Page County Recreation Leagues or Activities. I hereby release any and all rights and claims for damages I may have against anyone associated with the Page County Recreation Leagues or Activities, or any other group or organization in whose building or grounds this activity is being held, and instructors or persons of these groups for injuries received in participating in any sponsored activity. I also agree to abide by any and all rules and regulations set forth by the Page County Recreation Leagues and Activities."
Signature
“These materials and the activity described herein, are not sponsored or endorsed by Page County Public Schools.”
Submit
Should be Empty: