Tregnan Golf Academy - City of Los Angeles Department of ...

SUMMER CAMP 2014GENERAL INFORMATIONThe Academy Summer Golf Camp is a great opportunity foryouth ages 7-17 who have never played the game before andfor those interested in improving their skills and knowledgeof the game. This week long camp will include professionalinstruction in full swing, chipping, pitching, putting, bunkerplay, course strategy, and much more.We will host 6 sessions this summer: June 9-13, June 16-20,June 23-27, June 30-July 3, July 7-11, July 14-18,July21-25, July 28-August 1 and August 4-8, 2013. The sessionwill begin at 8am each morning and end at 12pm. The sesssionis limited to 40 campers. Participants must provide their own transportation.There are no refunds for missed days.REGISTRATION INFORMATIONRegistration will begin on Tuesday, May 5, 2014 at 10am. Campers will be accepted on a first-come,first-served basis. Application and fee must be submitted at least one week prior to session.Session includes: professional instruction, camp shirt, daily snack, and 9 hole tournament.Camp registration fee = $150/week. Session #4 =$120 / weekRegistration and payment must be complete by the Friday before the session.Summer Camp ApplicationJunior’s Name ____________________________________ Address ____________________________City ___________________________ Zip ____________ Home Phone __________________________Emergency Phone_________________________________ Parent/Guardian ________________________Male ___ Female ___ Age ___ (circle shirt size) Youth Small/ Medium / Large Adult Small / Medium / Large / X-LargeSession 1:_____June 9-13 Session 2:_____June 16 -20 Session 3:_____July 23-27Session 4:_____June 30-July 3 Session 5:_____July 7-11 Session 6:_____July 14-18Session 7:_____July 21-25 Session 8:_____July 28 - Aug. 1 Session 9:_____Aug. 4-8PARENT CONSENT FORMI, the undersigned, give permission for my child, whose name appears above, to participate in the Tregnan golf program. Iunderstand the nature of sports activities and the minor’s experience and capabilities and believe the minor to be qualified, ingood health, and in proper physical condition to participate in such activity. I give permission for my child to be transported byCity vehicles as a part of his or her participation in the Tregnan Golf Academy program. I agree to relieve the City of Los AngelesDepartment of Recreation and Parks, its officer agents and employees from any liability in connection with any injury to my childin connection with my child’s participation.I, the undersigned parent of _________________________________________, a minor, do hereby authorize City of LosAngeles, Tregnan Golf Academy as agents for the under-signed to consent to X-ray examination, anesthetic, medical or surgicaldiagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or specializedsupervision of any physician licensed under the provisions of the Medical Practice Act on the staff of a licensed hospital, whethersuch diagnosis or treatment is rendered at the office of said physician or a said hospital. It is understood that this authorizationis given in advance of any such diagnosis, treatment or hospital care which the aforementioned physician in the exercise of hisbest judgement may deem advisable. This authorization shall remain effective for the duration of the program, unless revokedsooner in writing and delivered to the Academy’s Executive Director.I understand that the program carries no insurance. I understand that I will be responsible for equipment provided by the programand that all equipment remains the property of the junior golf program.I agree to allow the use of any photographs and or images of my child participating in any sponsored event for any promotionaland/or marketing materials.Persons authorized to pick my child up are: I give my permission for my child to sign him/herself out? Yes NoName _________________________ Address _____________________________________ Phone ________________Name _________________________ Address _____________________________________ Phone ________________Signature of Parent or Legal Guardian __________________________________ Date _______________