Jensen Beach GOLF ACADEMY

"15th Annual"  2011

Fall Kids Golf Camp

Hosted by Golf Professional Bob "Bobby P" Petelinkar PGA

Only $295 per student (10 weekly sessions occurring every Monday)

Monday A fternoons From 4:00 to 5:30

Sessions: Begin the Week of Sept. 12th

Sessions: End the Week of Nov. 21st

(Checks payable to: Jensen Beach Golf Academy U.S. Mail - 76 Golf World - 1413 SW Heather Terr. Stuart, FL 34997

  Golf instruction, rules, etiquette, manners, sportsmanship, respect for others and the golf course, golf course safety and hole play.

Name:____________________________ Age:_____ Phone: (____) __________

Address:__________________________________________________________

City:___________________________________ State:_____ Zip:____________

Parent(s)/Guardians Name:___________________________________________

Emergency Contact/Phone:___________________________________________

   Drop off Payment at the 76 World Golf - 6801 S Kanner Hwy. Stuart, FL 34997

As parent or legal Guardian of the person named above, I hereby grant permission for him/her to participate in the Fall Kids Golf Camp offered by The Jensen Beach Golf Academy. Owners, managers, instructors, management of the academy and any of their heirs and/or assigns are hereby released from any liability from accidents, lawsuits or any elated action from any of the above parties.

Parent/Guardian Signature:_________________________________ Date:____________

Phone: (772) 486-6483           E-Mail: bp@bobbypgolf.us       Website: www.bobbypgolf.us & www.bobbypgolf.com