Junior Trackout Golf  Camp
Application Form - 2008

Name:________________________________________________

Street Address:___________________________________________________

City: _______________________________ Zip: ________________________

Day Phone: _____________________  Night Phone:____________________

E-mail Address: __________________________________________________

Age:  _________________________  Grade: ___________________________

Camp Track Number ________________ Date:__________________

Medical Conditions or Concerns: ____________________________________

 _____________________________________________________

We (parents) ____________________________________accept full responsibility
for the behavior of my child while he/she participates in the Wil~Mar Junior Golf Program. 
If safety rules discussed by the instructors are broken by my child, we understand that
he/she may be suspended from the program.  We have discussed this possibility with our child.

Signature:  ____________________________________________

Date of payment: _______________________________________

Mail application and payment ($145.00) to:

Fran Wilkerson
Wil~Mar Golf Club
2300 Old Milburnie Road
Raleigh, NC 27604

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