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Arnold Palmer Invitational Presented by MasterCard
The First Tee of Central Florida Youth Day
Junior Clinic

Featuring  PGA TOUR Player Stewart Cink

Monday, March 14, 2016
5:00 PM - 6:30 PM
Arnold Palmer's Bay Hill Club and Lodge

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Contact Information
Participant's First Name:
Participant's Last Name:
Parent or Guardian's Name:
Zip Code:
How can we contact you
Home Phone:
Mobile Phone:
Email Address:
Participant Information
Gender
Ethnicity
Age
Grade
School
Health Information
Are there any health conditions/disabilities (mental and physical) our staff should be aware of? Yes   No  
If yes, then please describe
Emergency Contact Information
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone Number

Health Consent 

In the event that I cannot be reached in an emergency, I agree to accept any and all determinations of need for medical assistance and/or administration of medical attention deemed necessary by The First Tee of Central Florida representatives and/or employees of Arnold Palmer's Bay Hill Club and Lodge, Arnold Palmer Invitational, or medical staff on hand. I hereby give permission to the medical personnel selected by The First Tee of Central Florida representatives to secure any and all medical, hospitalization, dental, and/or surgical treatment. In event that such medical attention is needed from a healthcare provider, all costs shall be the responsibility of the parent or guardian.

Initial

Media Release 

I hereby give The First Tee of Central Florida, The First Tee Home Office, and participating agencies permission to use film, video tape and/or photographs of the above mentioned minor for lawful promotional or infomational purposes.

Initial

I, the parent/legal guardian of the above named youth, give approval for participation in The First Tee of Central Florida sponsored activities. I assume all risks of injury whatsoever and agree to hold harmless The First Tee of Central Florida and The First Tee Home Office from claim(s) of any nature arising from any activity, connected with The First Tee of Central Florida Program. This hold harmless agreement includes, but is not limited to, any claim due to injury proximately resulting from negligence of The First Tee of Central Florida or The First Tee Home Office, its employees, agents, LPGA and PGA Professionals, participating agencies, and volunteers.

I consent to The First Tee of Central Florida and The First Tee Home Office communicating information regarding my child’s participation via the internet.

Submission of this online registration form will serve as parent/legal guardian consent for participation.

Form Completed By
Parent/Legal Guardian Name
Parent/Legal Guardian E-Mail Address
Witness Signature
Date

  

* Bold Fields are Required