Name_______________________________________________
Address_____________________________________________
City____________________ State___________ Zip__________
E-mail______________________________________________
(E-mail is our primary means of contacting members)
Home Phone______________ Emergency Phone____________
Mother's Name_______________________________________
Father's Name________________________________________
Birth Date_______________ Male or Female (circle one)
Shirt Size (adult/child)__________________________________
Amount of Golf Experience_______________________________
Avg Score 9 holes___________ 18 holes___________
I agree to allow my child to participate in Southern Arizona Junior Golf Association events.
I agree that in the event of physical injury or personal loss that there shall be no liability on the
part of any course, city, club, volunteers, and/or the Southern Arizona Junior Golf Association.
Parent/Guardian (print)______________________________________________
Parent/Guardian Signature ___________________________________________
Full Membership = $60.00 (includes annual dues = $30 and team uniform = $30)
Full Membership allows members to participate in all SAJGA events.
Please return to: Don Parkhurst : 9921 S. Placita de la Bondad, VAIL, AZ 85641
Make Checks payable to (SAJGA) the Southern Arizona Junior Golf Association