Program Registration

Registration Form

Please complete and submit the form below

First Name

Last Name

Gender

Age

Date of Birth

Graduation Year

Program You Are Registering For

Golf Experience

Have Golf Equipment?

Parent/Guardian First Name

Parent/Guardian Last Name

Relationship

Parent/Guardian Phone

Parent/Guardian Email

Emergency Contact First Name

Emergency Contact Last Name

Contact Relationship

Emergency Contact Phone

Emergency Contact Email

Please List ANY Allergies or Special Circumstances.

PHOTO RELEASE AND INDEMNIFICATION CLAUSE AUTHORIZATION

Permission is hereby granted for participant to appear in still or motion pictures using participants' name for educational, promotional, or other purposes only. In consideration for myself or my child to participate in the above program, I, the participant, parent or legal guardian of a participant agree to protect, defend, reimburse, indemnify and hold The First Tee Palm Beaches/Children Golf Foundation, PLA Golf Inc., Wellington National Golf Club, and Palm Beach County, their agents, designees, employees, and board of d!rectors free and harmless at all times from and against all claims, liability, expenses, losses, costs, fines, damages or causes of action of every kind and character, including attorney's fees and costs, whether at trial or appellate levels or otherwise, arising during, as a result of, or in connection with my or my child's participation in this program. I hereby assume the risk of participation in this program and agree to hold The First Tee Palm Beaches/Children Golf Foundation, PLA Golf Inc., Wellington National Golf Club, and Palm Beach County, their agents, designees, employees, and board of directors free and harmless at all limes from and against all claims , liability, expenses, losses, costs, fines, damages or causes of action of every kind and character, including attorney's fees and costs, whether at trial or appellate levels or otherwise, due to their acts, errors or omissions resulting in bodily injury, including death, or damage to my or my child's property incident to or in connection with my or my child's participation in this program. Permission is hereby granted for participant above to participate in The First Tee Palm Beaches/Children Golf Foundation, PLA Golf Inc., and Wellington National Golf Club programs including community outings, and authorization is hereby given for emergency medical care of said participant. I have read the above and understand ii and hereby agree that I will not hold The First Tee Palm Beaches/Children Golf Foundation, PLA Golf Inc., Wellington National Golf Club, or Palm Beach County liable for any injuries that may occur as a result of participation in the recreation activities provided The First Tee Palm Beaches/Children Golf Foundation, PLA Golf Inc., or Wellington National Golf Club.

Program Registration

Program Registration

Registration Form

Please complete and submit the form below

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