The Downriver Junior Golf Tour Membership Application

Name                                                                                                                            Phone

Address

City, State, Zip

Player Email:                                                                                                        Parent Email:

Parent Name(s) and Emergency Contact Numbers:

Birth Date                                                                   Age on August 21                                          (determines which age division)

Please Circle One:                                Male                    Female                         Average 18 hole score

By signing below, the member and parents agree to follow the rules and guidelines of the Downriver Junior Golf Tour, and also give permission to use the members name and likeness in any promotional materials. In addition, the player and parent agree to release the Downriver Junior Golf Tour, its officers, directors, independent contractors,successors, all hosting facilities and staff, sponsors, volunteers, and employees from any and all liability for any event or consequences whatsoever in any way arising out of or relating to participation in the Downriver Junior Golf Tour.

In Case of emergency, I authorize a licensed medical doctor to take all necessary measures in the treatment of player.

Player Signature:                                                                                                                                                            Date

Parent or Guardian Signature - Application is Invalid if not signed by parent / guardian                                   Date


Please complete this form and mail with tour payment of $90 by check to:
Downriver Junior Golf Tour, 2755 Rutledge Ct. Winter Haven FL 33884

Questions? Please call (734)- 731-0189 or visit the website at www.downriverjuniorgolftour.com