Parent/Guardian Name ____________________________________________________________________

Junior's Name ________________________________________________________________   Age ______

Address  ________________________________________________________________________________

City  ________________________________________________________  St ___________  Zip__________

Daytime Phone  _________________ Additional Contact  _________________  Number  _________________

I (we) as parent/guardian, and the participating junior, will hold Windsor Parke Golf Club (Club), its agents, employees and representatives harmless for any and all loss, injury or damage which may occur to the property or persons for the use of any equipment, facility, privilege or service whatsoever owned, leased or operated by the Club.  We agree to follow the rules and regulations of the Club as well as standards or etiquette and rules of golf.

Agreed:  __________________________________________________     Date:  _______________________

                Signature of Parent or Legal Guardian Required for attendance

Juniors approx skill level  Beginner    Intermediate    Skilled

* Payment is due at time of registration - Cash, or Local Check accepted

* This session limited to the first 36 Juniors to sign up.  * Call Mark or Chris at 223-GOLF (4652) for details.