Waiver Release Form

| Home | Jr Golf |


Please print, fill in and return this form to the golf course.

                While direct supervision of each junior golfer may not be possible at all times, an attempt will be made to have them supervised as much as possible. With that in mind, being fully aware that there are inherit dangers possible to participants in the game of golf, I do hereby give my son or daughter permission to take part in the Three Rivers Junior Golf Camp, not holding the course or the Kelso/Longview Elks Club responsible for any injuries to my son or daughter incurred during the Elks Junior Camp.

______________________________                        ________________________________
        Child's Name ( please print )                                    Parent/Guardian Name ( please print )

______________________________                        ________________________________
                        Date                                                        Parent/Guardian Signature

Childs Age    ______                                                    Boy/Girl    _____________

{ Below Information - Pro Shop Only }
            Amount Paid: __________                                Received By: _____________________