Entry Form - KO Junior Golf Tour

KO Junior Golf Tour Entry Form

Player Name__________________________________Birthdate____________________

Mailing Address_________________________________________________________________

City_____________________________State____________Zip Code_________________

Parent Name______________________________________________________________

Home Phone__________________________Parent Cell Phone_______________________

Parent Email___________________________________________________________________

Event Golf Course______________________________Event Date__________________

Event Golf Course______________________________Event Date__________________
Event Golf Course______________________________Event Date__________________

Please Circle Division:

Girls Open Boys Open Girls Masters Boys Masters Coed Futures

KOJGT Member? Yes No (If No, please add $20 "non-member" fee to your entry)

Parents are required to serve as a "walk along" scorekeeper in at least two events each year

Is parent available to serve as "walk along" scorekeeper in this event? YES NO

I, for myself and the player hereby release the host facility, the KO Junior Golf Tour, its officers, directors, and employees from any and all liability for any event or consequence whatsoever in any way arising out of or relating to member's participation in a KO Tour event with the sole and singular exception of liability arising out of bad faith or willful misconduct. I understand and support the KO Junior Golf Tour's Code of Conduct.
In case of emergency during a KO Junior Golf Tour event, I authorize a qualified medical doctor to take all necessary measures in the treatment of the aforementioned event participant. Parent/Guardian authorizes the KO Junior Golf Tour permission to utilize member's image, likeness, actions & statements in any live or recorded audio, video, electronic or photographic display or other transmission or reproduction thereof made of or at a tournament/event without further authorization or compensation.

Parent Signature______________________________________Date_____________

Amount Paid: Please Circle One

Futures 6 Hole Division Member $10 Non-Member $30

Masters 9 Hole Division Member $15 Non-Member $35

Girls Open 9 Hole Division Member $15 Non-Member $35

Open 18 Hole Division Member $20 Non-Member $40

Please Mail Completed Entry Form with Payment to:

KO Junior Golf Tour

P.O. Box 5112

Limerick, PA 19468