Junior Golf Academy Registration

Student First Name: *

Student Last Name: *

DOB: *

Age: *

Grade: *

Address:

City:

Parent # 1: *

Phone: *

Email: *

Parent # 2:

Phone:

Email:

Preferred Start Date: *

Select a Class Day & Time: *

Tuesday 4:00 to 5:30 pm

Wednesday 4:00 to 5:30 pm

Thursday 4:00 to 5:30 pm

Friday 4:00 to 5:30 pm

Saturday 8:30 to 10:00 am

Saturday 10:30 am to 12 pm

Saturday 1 to 2:30 pm

Player Experience: *

None

Some Driving Range

Some Golf Experience

Golf Club Needs: *

I Will Bring My Own Clubs

I Will Use Jane's Clubs

Special Needs or Restrictions:

If you are human, leave this field blank.