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Emerging Stars Registration
Welcome to the Emerging Stars program!
Participating Junior's First and Last Name:
*
Parents' First and Last Names:
*
Phone - Best Number(s) to Reach You:
*
Email:
*
Alternate Emergency Contact - Name and Phone:
*
Junior's Height (important for club fitting):
*
Junior's Date of Birth (Month/Year):
*
Please list other sports your junior has participated in:
*
Does your junior have any injuries, physical limitations, or allergies that the coaches should be aware of? If no, then write "none." If yes, please list.
*
Parent Permission Form and Medical Release of Liability
In case of an emergency or in the event that you cannot be reached during a Paul Weyland Golf Junior Program, you agree to accept any and all determinations of need for medical assistance and/or administration of medical attention deemed necessary by Paul Weyland Golf, LLC staff. You give permission to Paul Weyland Golf, LLC staff and/or representatives to secure any and all medical, hospitalization, dental, and/or surgical treatment in event of an emergency or urgent medical matter. In event that such medical attention is needed from a health care provider, all costs shall be the responsibility of the parent or guardian. You give Paul Weyland Golf, LLC permission to use video and/or photographs of the minor on this application for lawful promotional or informational purposes without further authorization or compensation. You, the parent/legal guardian of the applicant, give approval for participation in the Paul Weyland Golf, LLC Junior program. You assume all risks of injury whatsoever and agree to hold Paul Weyland Golf, LLC from claim(s) of any nature arising from any activity, including transportation, connected with Paul Weyland Golf, LLC and/or facilities. This hold harmless agreement includes, but is not limited to, any claim due to injury proximately resulting from negligence of Paul Weyland Golf, LLC, its employees, agents, and volunteers.
As the parent or legal guardian of the junior named on this registration form I agree to the terms listed above.
*
Yes
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