Pine Needles - Pine Needles Lodge & Golf Club / Mid Pines Inn & Golf Club
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Youth Golfari - Registration Form
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Registration Form
One Application per person, please.
Child's First Name
Child's Last Name
Nickname for Name Tag
Parent(s) or
Guardian Name
Address
City
State/Prov
Select One
AE
AK
AL
AP
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MP
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
AB
BC
MB
NB
NF
NT
NS
ON
PE
QC
SK
ST
YT
Other
Zip/Postal Code
Phone
E-mail
Age at time of Camp
Birth Date
Weight
Height
Gender
Select One
Male
Female
Grade in Fall 2008
Golf Shirt Size
Select One
Youth Med (10-12)
Youth Lrg (14-16)
Youth X-Lrg (18-20)
Adult X-Sm
Adult Sm
Adult Med
Adult Lrg
Adult X-Lrg
Please enroll my child
in the following Pine
Needles Youth Golfari
(please check each your
child will attend):
June 29th - July 6th, 2008
July 6th - 13th, 2008
July 13th - 20th, 2008
Has your child attended
Golfari before?
Select One
Yes
No
If yes, when?
How many?
Please indicate your child's skill level so we can place you in the correct group?
No Golf Experience
New golfer, but no on course experience
New golfer with some on course experience
Play left handed
Play right handed
Current USGA
Handicap 18-Hole
Current USGA
Handicap 9-Hole
18-Hole Average Score
9-Hole Average Score
Reservations and information:
(800) 290-2334
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