EmailMe Form - SWSJG - Sisters Who Swing Junior Golf

Name
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone
### - ### - ####
Email
School Attending / Location
Academic Grade *
Current GPA
Birth Date
Parent/Guardian *
First Last
Cell Phone
### - ### - ####
Email
Home Phone
### - ### - ####
Authorization and Consent *
This Authorization and Consent to Use Photograph(s) or Image(s) is given by the undersigned to SWS Junior Golf Program for use by SWS Junior Golf Program
Authorize and Consent Photograph's
YES
NO
Emergency Medical Treatment
In case of emergency during a SWSJG sponsored tournament or qualifier, I, as the parent and/or guardian of the tournament/qualifier participant, authorize a qualified medical doctor or on-site medical staff to take all necessary measures in the treatment of the aforementioned participant.
Authorize medical treatment?
YES
NO
Annual Membership Price
$ Dollars . Cents