Entry Fee for all Girls is $85 per girl which covers 36 holes of golf.
(TGTJT membership fee for Girls is waived for this event only)

Name __________________________________________ Birthdate ___/___/___ M/F ______
**( as you wish it to appear on scoreboard, etc.) **Playing Age is age as of Oct. 16, 2007

Address _____________________________ School ___________________________

City _______________________ St _____ Zip _______ Grade in School ______

Graduation Year_____ and Yes_____ I give my permission for my child's name, city, state, and graduation year to be released to the following associations for purposes of national ranking and score posting: National Junior Golf Scoreboard, www.juniorgolfscoreboard.com.
Or
No _______ I do not want my child's graduation year used when submitting scores for ranking purposes.

Yes do ___ or No do not____ : release permission for my contact information to be provided to interested Coaches and/or teaching professionals for recruiting purposes (High School ages only).

______________________________________ ________
Parent or Guardian Signature date

Email Address ___________________________________ Home Ph ___________________
(please provide email address to be used for information )

Parent / Guardian________________________________ Work Ph____________________

$ _______ Fee Paid (non refundable after Aug 10)

Will accept Visa or MasterCard (please circle card type) * $3. processing fee

Account #: ______________________________________

Name as on Card: ______________________________________

Expiration Date: _______________________

Signature: __________________________________________

WAIVER:

I hereby authorize __________________________ to participate in the Triad Golf Today Junior Tour. I understand that the Triad Golf Today Junior Tour, Triad Golf Today magazine as sponsor, volunteers and participating facilities are not liable for accidents or injuries sustained while playing or participating in junior events. I agree to fully indemnify and hold harmless Triad Golf Today Junior Tour, Triad Golf Today magazine as sponsor, volunteers and participating facilities from damages sustained in any event. I FURTHER HEREBY GRANT AUTHORITY TO ADMINISTER FIRST AID OR MEDICAL TREATMENT AS REQUIRED TO THE ABOVE NAMED CHILD WITHOUT THREAT OF LEGAL ACTION.

PARENT/GUARDIAN _________________________________________ DATE ________
Please make checks payable to TGTJT and mail to: Triad Golf Today Junior Tour, 5410 Mockingbird Rd. , Greensboro, NC 27406
**There will be a $25 returned check fee and a $10 declined charge card fee**

For further information, contact Tour Director/Owner Wendell Welch at (336) 674-1900 (telephone and fax)or Visit our web site at www.tgtjt.com and email your questions to us at triadgolfjrtour@aol.com