MONTHLY CLINIC

First Name (required)

Last Name (required)

Date of Birth (for Gate Security)

Driver's License Number

Email (required)

Zip Code

Role (Select All That Apply)
Adaptive GolferAble-Bodied GolferNon-Playing VolunteerSponsorFirst Time

Do you need adaptive equipment to participate?
YesNo

Are you a Veteran?
YesNo

Will you be staying for lunch? (Sponsored by Gateway Mortgage)
YesNo

Lunch Selection
NoneGrilled Chicken WrapCheeseburgerVeggie WrapHot Dog

Side Selection
NoneFriesChips

Select month you will attend.
MarchAprilMayJuneJulyAugustSeptemberOctoberDecember

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.