Application

Please print the application form, fill it out, and bring it in with the $50.00 yearly registration fee. You may also email this to lin@sephlin.com

Student First Name

Student Middle Name (optional)

Student Last Name

School Attending

How old will your child be when they start out the school year?

Parent/Guardian First Name

Parent/Guardian Middle Name (optional)

Parent/Guardian Last Name

Address

City

State/Province

Postal/Zip Code

Country

Student Email (optional)

Student Mobile Number (optional)

Parent Email

Parent Mobile Number

Golf Experience: Golf Experience: Beginner Intermediate Advanced

Does your child have any disabilities/special needs?

If yes, please provide details

Parent Signature

Date of Signature

Student Signature

Date

6 + 15 =