Junior program application Please fill out the form below First and Last Name Player phone number Player email Birthdate School Junior Program Level Level 1 - Train to Play Level 2 - Train to Compete Level 3 - Train to Win Evergreen Team Dietary Restrictions Social Media Handles Name Phone Email Address City Zip Name Phone Email Address City Zip Name On Card Card Number Expiration Date Zip CSV I, the undersigned, am undertaking to use the facilities and equipment of EGC, LLC (the Club”) in connection with golf-related activities, which may include the use of golf clubs and the driving of golf balls in an indoor setting in near proximity to other users, visitors, invitees or observers, and other uses of Club equipment or facilities. I understand that such activities can be HAZARDOUS, and that in using Club equipment or facilities l understand and accept such risks and dangers whether they are marked or unmarked. I also recognize that the use of Club facilities or equipment be a strenuous physical activity that may require movements such as bending, lifting, or twisting. I realize that slips, falls, and other accidents do occur and serious injuries or death may result from such activities and I assume full responsibility for these risks. IN CONSIDERATION FOR ANY USE OF THE CLUB EQUIPMENT, FACILITIES, VEHICLES, OR ENVIRONMENT, I HEREBY RELEASE AND AGREE TO HOLD HARMLESS AND INDEMNIFY EGC, LLC, ITS SUBSIDIARIES, EMPLOYEES, INSTRUCTORS OR AGENTS FROM ANY AND ALL CLAIMS AND LIABILITIES ARISING OUT OF OR IN CONNECTION WITH THE USE OF SUCH FACILITES AND EQUIPMENT. I certify that I am in sufficiently good physical condition to withstand physical strain and exertion, and I assume all such risks by requesting entry into the Club facilities or use of Club equipment. I am aware that none of the staff or instructors of EGC, LLC are trained to provide medical assistance or treatment to any Club participants. On behalf of myself, my heirs, executors, and administrators, I do hereby waive and release all rights and claims for damages I might accrue against EGC, LLC and against any of its managers, members, employees, officers, or instructors, or their successors, representatives and assigns, for any and all injuries suffered by me while participating in any activities at or connected in any way with any EGC, activities, classes or programs. PARENT/GUARDIAN SIGNATURE REQUIRED Date: Confrimation: By checking this box, I confirm that I have filled out all this information correctly and have read the Liability Waiver carefully and agree to the terms of Evergreen Golf Club's Liability Waiver. SUBMIT
