Student Information:
Name of Student:
Age
Tee Shirt Size (Prep, Par, Birdie, Eagle camps only):		na YM YL AS AM AL AXL AXXL
Right / Left Hand:		Right Hand Left Hand
Own Clubs:		Yes No
Name of Contact: (parent if student is under 18)
Home Phone:
Cell Phone:
Email:

CLINIC SELECTIONS:
ADULT CLINICS:
Wednesday Ladies Instructional Clinics    $35 per session		To Purchase, Choose Session Here May 1 May 8 May 15 May 22 May 29 June 12 June 19 September 4 September 11 September 18 September 25 October 2 October 9 October 16
Wednesday Ladies On Course Clinics    $60 per session		To Purchase, Choose Session Here May 1 May 8 May 15 May 22 May 29 June 12 June 19 September 4 September 11 September 18 September 25 October 2 October 9 October 16
Friday Ladies Clinics    $60 per session		To Purchase, Choose Session Here May 3 May 10 May 17 May 24 June 7 June 14 June 21 September 6 September 13 September 20 September 27 October 4 October 11 October 18
Executive Clinics    $35 per session		To Purchase, Choose Session Here May 2 May 9 May 16 May 23 May 30 June 6 June 13

Special Requests: (ie., Limited Sun, Allergies, etc.)

PAYMENT OPTION #1 - (HOUSE ACCOUNT): (To charge your registration to your membership house account, enter your 5 digit membership number)
Membership #:
PAYMENT OPTION #2 - (CREDIT CARD): (Information below must match info on credit card)
Name
Address1:
Address2:
City:
State:
Zip:
Telephone:
For your convenience we accept:
Credit Card:		- American ExpressMastercardVISA
Credit Card #:
Expire Date:		- MM-YY

Cancellation Policy:
Your credit card will be used to hold your spot in the clinic and will be billed one week prior to the first clinic date. Any cancellations received one week prior to the first clinic date will NOT be charged. Cancellations received after the one week prior date, but at least 3 days prior to the first clinic date will be credited back the full amount in Golf Academy credit. Any cancellation received 3 days prior to the clinic will be credit back 50% Golf Academy Credit. No shows will be charged in full, without the opportunity to reschedule.

Cancellation policy for Half Day Camp and Full Day Camp are different, please call for details.

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