THE FIRST TEE of the FOOTHILLS Participant Permission Form

THE FIRST TEE OF THE FOOTHILLS Does your child need clubs? Participant Permission Form YES NO Previous participant at The First Tee: YES NO Please circle - Target(ages 5-6) Player (ages 7& Up) Par I/II/III (ages 9 & up) Birdie (ages 11& up) Mondays 4:00-5:00 pm Mondays 5:15 – 6:30 pm Tuesdays 4:00-5:15 pm Tuesdays 5:15 – 6:30 pm FIRST COME, FIRST SERVE! REGISTER NOW! CLASSES LIMITED TO 12 PARTICIPANTS! Youth Information: Name: Prefers to be called: Shirt Size: Address: City: State: Zip: Birth Date: Age: School: Grade Level: Male: Female: (Circle): African-American Asian Caucasian Hispanic Native American Pacific Islander Other Parent / Legal Guardian: Relationship to child: Work Phone ( ) Home Phone ( ) Cell Phone ( ) Other Phone ( ) Email Address(s): Participation Consent Form Completed by: Mother Father Legal Guardian Emergency Contact Information Emergency Contact: Relationship: Phone: (If parent / guardian cannot be reached) Health Information: Medication(s) required: Please circle Yes or No List medications: Please circle all that apply: Asthma Diabetes Epilepsy Allergies Other: 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 representatives. I hereby give permission to all the medical personnel selected by The First Tee representatives to secure any and all advised hospitalization, medical, dental and or surgical treatment. In the event that such medical attention is needed by a healthcare professional, all costs of such care shall be borne by the parent or gu ardian. Parent/Guardian Signature: Equipment & Facilities: I/We hereby understand that any golf equipment received for use is property of The First Tee Program, and must be returned upon termination of the participant’s involvement in the program. I/We understand that access to the facilities and/or equipment may be limited due to class/camp use. A phone call to ascertain availability is recommended. Parent/Guardian initials: Media Release: I/We hereby give The First Tee and participating agencies permission to use any film, videotape and photographs of the above minor for lawful promotion or informational purposes. Parent/Guardian initials: I/We the parents/legal guardians of the above named youth give approval for participation in The First Tee of the Foothills sponsored activities. I/We assume all risks of injury whatsoever and agree to hold harmless The First Tee program from claim(s) of any nature arising from any activity including transportation, connected with The First Tee program. This hold harmless agreement includ es, but is not limited to, any claim due to injury proximately resulting from negligence of The First Tee, its employees, agents, LPGA and PGA Professionals, participating agencies and volunteers. Parent/Guardian Signature: Date: - Please turn over and discuss rules and guidelines with your child – THE FIRST TEE OF THE FOOTHILLS Junior Golfer Rules and Guidelines Welcome to The First Tee of the Foothills. We welcome all juniors to enjoy the game of golf. The staff at the First Tee want all golfers to have fun. You will be learning LIFE SKILLS and GOLF SKILLS during your classes. You will be expected to participate in all aspects of class activities and lessons. Life skills and golf skills include certain guidelines that are listed on this page. The following Rules and Guidelines apply to everyone attending classes at The First Tee. Certification: To receive your Certification you must: Complete all required lessons Pass the Certification written test Pass the instructor’s evaluation Complete at least 1 round of golf (9 holes) Receive a positive life skills evaluation The First Tee Dress Code: Shirts: Juniors must wear and tuck in golf shirts while on First Tee property. Shorts and Slacks: Shorts must have a hemline no shorter than 6 inches above the knee. Shorts and slacks must be of neat attire meaning: items with holes, sweat pants, “baggie” jeans, spandex and gym shorts are not acceptable. In addition, the waistline of shorts and slacks must not hang lower than 2 inches below the navel. Shoes: Only rubber spike golf shoes or tennis shoes may be worn. Attendance: Golfers are to arrive at least 10 minutes early to check in and to receive their equipment and instructions. Weather Conditions: During inclement weather, cancellation will be determined 1 hour before the start of the program. Please call the clubhouse at (704) 484-6823 to confirm cancellations. Please note that due to the unpredictability of the weather, advanced notice may not be possible. Expected Behavior: Always respect others, the equipment and the golf course. Allow everyone to participate. Be considerate of others while practicing and playing. Appreciate, be considerate of, and respectful to all First Tee staff members. Dress appropriately. (see dress code) Improper language will not be tolerated. Infractions of these rules will not be accepted. If there are any incidents with the above listed behaviors, the golfer will be asked to leave the class with the possibility of no return. Parents will be notified to pick the child up immediately. If a junior golfer is asked not to return to classes, a refund will NOT be issued. I agree to all terms listed above and will abide by the rules and guidelines of The First Tee of the Foothills. Junior Golfer Signature: Date: Parent/Guardian Signature: Date: .

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