Winter Camps - Mike Bender Golf

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Student Name *

First

Last

Age of Junior? *

Gender: *

Player's Average Score: *

Has Player competed in a tournament this year?

Does your junior have any medical concerns or allergies?

Parent/Guardian Name *

First

Last

Relationship to Student *

Phone Number *

Email Address *

Mailing Address *

Single Line Text *

Emergency Contact Name:

Emergency Contact Phone Number

Player's Shirt Size: *

Player's Hat Size

* Which session would you like to attend? *

Phone

Single Line Text *

Child's Height: *

Child's Age: *

* Which Camp Dates are you registering for?

Do they have their own golf equipment? *

* How long have they been playing golf? *

* Do they have friends attending camp with them? *

Email

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