Reynolds Plantation Golf Camp Registration Form

Georgia Golf Ministry 720 West Lake Drive Athens, GA 30606-4120 O) 706.354.8380 F) 706.621.6589 [email protected] www.gagolfministry.com

2008 FCA Golf Camp Registration Form Select Camp

_____ - Jekyll Island Junior Golf Camp June 1 – 4, 2008 Fee - $ 695.00

_____ - Jekyll Island Junior Golf Camp June 5 – 8, 2008 Fee - $ 695.00

_____ - Reynolds Plantation Junior Golf Camp July 13 – 17, 2008 Fee - $ 895.00

_____ - Reynolds Plantation ELITE Junior Golf Camp July 17 – 20, 2008 Fee - $ 895.00 Camper Name: ______Parents/Guardians: ______(Both names if applicable, please) Address: ______City/State/Zip: ______Date of Birth: ______Male: ____ Female: _____ Home Phone: ______Parent Work Phone: ______Parent Cell Phone: ______Parent E-mail: ______(PRINT ALL CAPS PLEASE) Camper E-mail: ______(PRINT ALL CAPS PLEASE) Campers Handicap or Average Score: ______

Please complete this entire form. Make sure you selected the appropriate camp. Submit a deposit of $200 per camper by check to GA Golf Ministry or fill in the credit card form below: Please enter this information exactly as it appears on your statement: * Credit Cards incur 2.5% bank fee. Charges appear as ‘AJGF’. Name on Credit Card- ______Credit Card Type- ______Address- ______Credit Card Number- ______City, ST Zip- ______Expiration Date- ______Card Verification Number- ______(This is the last 3-digit numbers on the back of the credit card or if American Express it is the 4-digit number on the front right-hand side of the card.) After you have filled out this form, please mail it to the address listed above. A complete itinerary will be mailed six weeks before each camp. We look forward to seeing you at the camp.

www.gagolfministry.com