Please complete the registration form below.
First Name (required)
Last Name (required)
Email (required)
Zip Code
Is this your first time attending one of our clinics? YesNo
Are you a Participant or Volunteer? ParticipantVolunteer
What adaptive equipment do you need (if any)? NONESolo RiderParamobile Right-HandedParamobile Left-HandedCaddy (assistant)Don't know yet
Are you a Veteran? YesNo
Will you be playing golf afterwards? YesNo
Do you have a DBIDS Card/Military ID? —Please choose an option—NeitherI have a valid DBIDS CardI have applied for a DBIDS CardI have a Military ID
Date of Birth (for access to MCRD Parris Island)
Driver's License Number (for access to MCRD Parris Island)
Driver's License State (for access to MCRD Parris Island) —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Will you be staying for lunch? (Sponsored by Gateway Mortgage) YesNo
Lunch Selection (select one) CheeseburgerHot DogChicken Wrap
Lunch Side (select one) ChipsFrench FriesNone
Select month you will attend. October
READ THE PHOTO RELEASE TERMS AND LIABILITY WAIVER FORMS. You will not be able to finish registration without agreeing to the photo release and liability terms.
I agree to the Photo Release terms.
I agree to the Liability Waiver terms.
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