Serving Buffalo, Niagara Falls, Rochester, Southern Tier, Erie, PA & Southern Ontario

   2007 GIRL’S VARSITY GOLF CLUB APPLICATION

Participant Information:

Name _______________________________________________Age_________ DOB _____________

Address_______________________________________________________________________________

Phone ___________________ Email________________________________________________________

Parent/Guardian __________________________________________ Phone ________________________

School__________________________________________________________ Grade ________________

 Golf Experience:

Please check the level that best describes your ability: 

____Level 1     New Golfer – Very little or no on-course experience 

____Level 2     Average over 75 for 9-holes on a regulation course

____Level 3     Average between 65-75 for 9-holes on a regulation course

____Level 4     Average between 55-64 for 9-holes on a regulation course

____Level 5     Play 18-holes with a score of 110 or better on a regulation course

____Level 6     Play 18-holes with a score of   95 or better on a regulation course

Do you own your own clubs? ________________________    Do you need practice clubs? ____________________

The weekly schedule for supervised practice sessions, and Instruction provided by Cindy Miller will be posted on the Upstate New York Junior Golf, Inc. website: www.upstatenyjuniorgolf.com .   We will attempt to practice outside as often as the weather permits.  Please dress accordingly.

 Lessons provided by Cindy Miller are also posted on her website: www.cindymillergolf.com under Junior Lessons, LPGA-USGA Girls Golf.

 COST:   $25 to enroll in the LPGA*USGA Girls Golf Club ($10 for renewing members)

$80 Instruction fee (includes 4 lessons)

$105 ($90 for renewing members) payable to: Cindy Miller Golf

$10 each indoor/outdoor practice session (Payable at each session attended)

Parents and/or Legal Guardian are required to read and sign below before their daughter is eligible to participate in the Girls’ Varsity Golf Club:

I understand that the Girls Varsity Golf Club, Upstate New York Junior Golf Inc. are not liable for and accidents or injuries sustained by my daughter when attending or participating in any Girls Varsity Golf Club event.

Print Name ______________________________ Parent/Legal Guardian Signature ____________________________

This application must be signed by the participant’s Parent/Guardian prior to participating in any event.

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