ATLANTIC COAST JUNIOR TOUR
TRIAD GOLF TODAY JUNIOR TOUR
TRIANGLE GOLF TODAY JUNIOR TOUR
Membership Application
Membership based on City location
All members are eligible to play in all TGTJT Regions
Name __________________________________________ Birthdate
___/___/___ M/F ______
**( as you wish it to appear on scoreboard, etc.) **Playing Age is age as of
Oct. 16, 2008 for 9/2008-9/2009
Address _____________________________ School ___________________________
City _______________________ St _____ Zip _______ Grade in School ______
Local Newspaper Email address: __________________________________________________________
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
to Junior Golf Score Board.
______________________________________ ________
Parent or Guardian Signature and date
Email Address ___________________________________ Home
Ph ___________________
(please provide email address to be used for information )
Parent / Guardian________________ _________________ Work Ph____________________
MEMBERSHIP FEES
Annual Membership fee $80, applies for a 12 month period
from the month you join. Each additional child annual membership fee $65.
Includes AAU membership thru 8/31/2009 (complete AAU form with copy of birth
certificate) see web site to obtain AAU form.
Membership fee to TGTJT $ _______ Fee Paid.
Will accept Visa or MasterCard (please circle card type) * $3. processing
fee
Account #: ____________________________________ 3 digit Code (on back) ______
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 or Visit our web site at www.tgtjt.com and email: triadgolfjrtour@aol.com