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2023 Golf Camp Registration Form
Please submit the form by May 19th
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* Indicates required question
Email
*
Your email
Camper First Name
*
Your answer
Camper Last Name
*
Your answer
Gender
*
Choose
Male
Female
Age
*
Your answer
Grade Entering 2023-24 School Year
*
Choose
6th
7th
8th
9th
10th or Higher
Shirt Size
*
Choose
Youth S
Youth M
Youth L
Youth XL
Adults S
Adult M
Adult L
Adult XL
Adult XXL
Club Type
*
Are you right handed or left handed when you swing a baseball bat?
Choose
Right Handed
Left Handed
Parent /Guardian Name
*
Your answer
Parent/Guardian Home Phone Number
*
Your answer
Parent/Guardian Cell Phone Number
*
Your answer
Parent/Guardian Work Phone Number
*
Your answer
Emergency Contact Name (Other than parent listed above)
*
Your answer
Relationship to Child
*
Your answer
Emergency Contact Home Phone Number
*
Your answer
Emergency Contact Cell Phone Number
*
Your answer
Emergency Contact Work Phone Number
*
Your answer
Is a bus needed to Cullom?
*
Yes
No
If a bus is needed, what town is the pick-up?
Piper City
Kempton
Cabery
Stelle
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