CRAVEN COUNTY RECREATION & PARKS

406 Craven Street, New Bern, NC 28560

Phone: 252.636.6606; Fax: 252.636.6685

GOLF REGISTRATION FORM

2017

Please print clearly

Participant Information
Participant Name: DOB: Age: □M □F
(If participant is a minor)
Parent / Guardian Name:
Address:
Street or PO Box City State Zip
Phone- Home: Work: Cell:
*If participant is a minor, please list email for Parent/Guardian.
Email:
Emergency Contact: Home Phone: Work Phone:
Class Information
Location: The Emerald Golf Club
Date: Tuesday, April 4 (4 weeks)
Time: 6:00 PM – 7:00 PM
Fee: $75/person OR $140/couple
Who: 16 & up
Description: This class will be every Tuesday for four weeks starting April 5. We will cover fundamentals of the game: Set-up, putting, chipping, pitching, full swing, rules and etiquette.
**If you are signing up as a couple, please list partner’s name: .
Waiver
I understand that registration in any program/event is on a first-come, first-served basis, and that Craven County Recreation & Parks Department, its staff and instructors, and/or sponsors will not be responsible for any injuries or loss that may result and occur from my/my child’s participation in the activity (ies) of my/his/her choice. I grant permission for any treatment deemed necessary for a condition arising from participation in any program/event, including medical, dental or surgical treatment recommended by a medical doctor. I also understand that refunds will be made only in the event of an activity being full, cancelled, or in case a change in the advertised date, time or site prevent me/my child from participating.
On occasion, CCRPD may take photographs of participants in programs, classes or events. These pictures may be used on our website or brochures for advertising or promoting our programs. In the event a picture is take of you and you wish to NOT have this photo used by CCRPD, please check here:
Signature (Parent/Guardian if under 18 yrs old) Date

Last updated 1/12/15