2011 Season Registration Form  

 
Name:_______________________________________________________________
Address: ____________________________________________________________
City/State/Zip:  _______________________________________________________
Age:_______        ___ Male  ___Female      Years Playing Experience: __________
Phone:(____)_____________    Email Address:  ______________________________
 
Registration Fee: (please CIRCLE & PAY the correct amount)
          Ages 14-17 or if playing 18 holes.......................... Cost: $265.00
          Ages 10-13 or if playing only 9 holes................... Cost: $220.00
   
Please Check the BWJGA Tournaments/Events You Plan On Attending:
 
 _____   6/20  Black River Country Club                        _____  7/11   St Clair River Golf Club
 _____   6/24  PH Elks Golf Club                                  _____  7/14   Fore Lakes Golf Club
 _____   6/27  Holly Meadows Golf Course                    _____   7/18   Burning Tree Golf Club
 _____   6/30  Belle River Golf Course                           _____   7/21   Lakeview Hills Golf Club
 _____   7/08  Port Huron Golf Club                               _____   7/25   Marysville Golf Course
 

I hereby give my consent for my son/daughter to participate in the BWJGA Tournaments/Events:

Parent/Guardian Name: ________________________   Signature:_________________________
Emergency Contact: __________________  Phone: (          ) ___________________
Volunteer Sign-Up
Name:_________________________    Phone:  ____________________ Email: __________________________

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For Office Use Only:
Amount Paid ______________  Total Paid _______________   Payment Type  _____________
Written Test __________  Skills Test _________   In Computer _________