CATSKILL MOUNTAINS

JUNIOR GOLF, INC

Gordie Faulkner, Pres/Exec Director

607) 652-2457 Home

(607) 267-9781 Cell

 

2016 JUNIOR GOLF APPLICATION

 

FIRST COME FIRST SERVED ONLY

Maximum is 70 Juniors at each Facility. Must be able to commit to 3 clinic days.

 

JUNIOR GOLFER NAME_________________________________________________

 

PARENT (GUARDIAN) NAME____________________________________________

 

ADDRESS______________________________________________________________

 

CITY, STATE, ZIP_______________________________________________________

 

TELEPHONE RESIDENCE________________________________________________

 

OFFICE____________________________________________________

 

CELL OR EMERGENCY______________________________________

 

E MAIL ADDRESS_______________________________________________________

 

DATE OF BIRTH_____________________AGE BY JULY 1st ____________________

 

PAST JUNIOR GOLF PARTICIPANT .YES or NO______WHERE______________

 

DESCRIBE EXPERIENCE_________________________________________________

 

FACILITY PREFERENCE: Ouleout Creek GC_______ or Shephard Hills GC_______

 

RT OR LT HANDED________DO YOU OWN CLUBS__Y_N___Height__________

 

SHIRT SIZE: YOUTH (sm, med, lg) ADULT (sm, med, lg, xl) Circle One

 

FEE $40.00 FOR ENTIRE PROGRAM, NO PARTICIPATION WITHOUT PAID FEE.

Make payment to: Catskill Mountains Junior Golf, Inc.

 

Send to Gordie Faulkner, PGA, 33 Prospect St., Stamford, NY 12167.

 

DO NOT LEAVE THIS APPLICATION AT THE GOLF SHOP-PLEASE, SEND IN.