After School Program
Full Swing Basics * Short Game Practice*Course Etiquette
*On-Course Play & Game Management Skills
12-March to 16-April, 2015
Thursdays 4:15 pm to 5:15 pm
Ages: 7 to 11 Years Old
Cost: $75.00 Person, $65.00 Additional Siblings
Includes: Range Balls, Green Fees & Instruction Fees
Equipment Provided if Needed
Maximum of Twelve Students in Session
Student Name:______________________________ Age:______
Gender:__________
School:____________________________________ Grade:_________________________
Address:___________________________________ Phone:_________________________
E-Mail:____________________________________ Parent Name:_____________________
Parent Phone:_______________________________ Parent Cell:_______________________
Physician Name:_____________________________ Physician Phone:__________________
Health Insurance:_____________________________ Policy #__________________________
I, the parent of______________________, give permission for my child to receive medical treatment or
emergency care, if necessary. I understand every effort will be made to contact me, or the named person
below, before taking this action. I hereby waive and release The Creek at Hard Labor Golf Course and its staff
from any liability for any injury or illness incurred while attending the after school program. I understand that
there is a risk of injury to my child as a result of golf activities, and knowingly and voluntarily assume all risk of
such injury. I will be financially responsible for any medical attention needed during the golf after school
program or resulting from an injury received at the golf after school program.
Parent Signature:________________________________________
Date:____________
Taught By: Karl Gross, PGA
E-Mail: [email protected]
Web: http://karlgrosspga.com
1400 Knox Chapel Road, Social Circle, GA 30025 706.557.3006 golf shop 706.557.3008 fax