North East Junior Golf Tour

2012

Tour Membership Application

(PLEASE PRINT)

Name____________________________________________________ Sex_______ Age as of 6/1/2012_____________

Address__________________________________________________________ Date of Birth______________________

City, State, Zip__________________________________________________________________ Handicap_____________

First Name You Go By (i.e. Robert or Bob)____________________________________

Health Problems_________________________________________________________________________________________

Home Telephone (______)_________________ Parents Work Telephone (_____)_________________

Member Last Year? Yes No

Parent/Guardian Name______________________________________________________________

Membership Fees

Annual membership fee per member - $35.00 due with application

Entry Fees are $40-$45 per event -- or see Package Deal

Two or more members per family – 10% discount for each member entry fees only

Package

This year the Package includes a11 15 tournaments you want to play in including the Tour Championship and annual membership fee for a prepaid cost of $320 (no discount for 2 kids).

This is limited to the first 20 who apply.

Hold Harmless Agreement

We understand The North East Junior Golf Tour, its Director, employees, volunteers, golf course owners, or employees can not be held liable for any damage or injuries suffered while participating in or traveling to or from a North East Junior Golf Tour event. We authorize use of and agree to hold harmless any publication used by the North East Junior Golf Tour. We also agree to abide by all rules and policies set forth by the North East Junior Golf Tour.

__________________________________ Date____________

Signature of Member

__________________________________ Date____________

Signature of Parent/Guardian

Send all fees to:

North East Junior Golf Tour

P.O. Box 59

Hollidaysburg, PA 16648