registration Form

Junior Golf Participant Registration Form

* Indicates required field

Participant Name *

First

Last

Date of Birth *

Gender *

2nd Participant *

First

Last

Date of Birth *

Gender *

Email *

Phone Number *

Parents Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Emergency Contact *

Health Concerns, Allergies or other Special Considerations: *

I understand that my signed Waiver and Release of Liability form is part of my registration. I also understand that primary insurance coverage is my individual or family plan. I have no objection to Carter's Spectrum Golf using a photograph of my child in promotional materials. I understand that this program may be cancelled due to inappropriate behavior or repeated unkindness. I understand that the program is no-cost for Broward County Residents.

Signature of parent/guardian *

Date *

I, the undersigned parent/person having legal custody/guardianship of *

give permission for said minor to participate in the Carter's Spectrum Golf Junior Golf Program. I certify that my minor is six (4) years or older, in good health and capable of participating in the Junior Golf Program.

In consideration of said minor being permitted to enter the Country Club of Coral Springs (the “Club”) and participating in the Junior Golf Program, I, on behalf of myself (as parent or guardian) agree as follows:

1. I acknowledge that minor’s participation in the Junior Golf Program may result in serious bodily injury or death. With these and similar risks in mind, on behalf of myself and my heirs, next of kin, executors, administrators, successors and assigns, I hereby fully and forever release, waive and discharge the owner and operator of the Club and each of its officers, directors, shareholders, employees, agents, contractors, attorneys, insurers, parents, subsidiaries and successors in interest (collectively, with the Club, the “Released Parties”) from all claims, demands, obligations, causes of action and/or liabilities for personal injury, property damage or wrongful death which now exist or may hereafter arise that relate in any way to my child’s presence, or participation in the Junior Golf Program at the Club.

2. In the event that any action, suit, claim or demand of any kind or nature is brought in the future asserting any claim against the Released Parties, I shall, to the fullest extent permitted by law, indemnify, defend and hold harmless the Released Parties against any and all claims, demands, actions, liabilities and expenses (including reasonable attorneys’ fees and costs) incurred by them in connection with the investigation, defense, settlement, trial or appeal of such action, suit or claim to the extent that such claims, demands, actions, liabilities and expenses (including reasonable attorneys’ fees and costs) arise from or relate to my minor child’s presence, or participation in the Junior Golf Program at the Club.

3. I assume full responsibility for, and risk of, bodily injury, death, or property damage due to the negligence of the Released Parties or otherwise.

4. I agree that the Club shall have the right, at its discretion, to enforce rules of conduct and/or terminate my minor child’s participation for failure to act in conformance thereof, or for his or her actions or conduct if detrimental to or incompatible with the welfare, comfort, harmony, course rules or interest of the Junior Golf Program as a whole. Golf course etiquette is taught and is strived for by all.

5. I hereby grant the Club Full authority to take whatever action, in their discretion, is determined to be necessary for my minor child’s health, safety and welfare, and I fully release the Released Parties from any liability for such actions, as set forth herein. I understand that the Club is not responsible for costs incurred for medical care.

6. I intend this document to be as broad and inclusive as is permitted by the laws of the State of Florida. If any portion hereof is held invalid, I agree that the balance shall continue in full force and effect.

Signature of parent/guardian *

Date *

Are you a Veteran ? *

Yes No Family of Veteran

Golf lessons, take place at the country club of Coral Springs.
10800 W Sample Rd
Coral Springs, FL 33065
Lessons take place weekdays and Saturday 5-7pm, .

Preferred day and time requested. *

Comment *

I agree to receiving marketing and promotional materials

Submit