The Emerald Greens Junior Golf Club Registration Form

Child’s name (first and last) ____________________________________________________________

Parent’s name(s) _____________________________________________________________________

Email__________________________________________________Phone______________________

Street Address_______________________________________________________________________

City______________________________________________________________ ZIP___________________________________

T-shirt size (100% cotton, please circle one):        10-12           14-16       adult small        adult medium       adult large       adult XL

Please list any friends with whom you would like to be paired:______________________________________________________

Choose your session:

First Choice:             Level_________________________________________       Current grade_________  Fee enclosed_______________

                             Day of the week____________________________         Time__________________________

Second Choice:        Day of the week____________________________         Time__________________________

Please send the registration form and fee to:

Barry Wallin
14172 Crocus Way
Rosemount, MN 55068

The week of August 6-9 will be used as a make-up week for any missed lesson, including those missed due to rainouts, illness, or family vacations. Also, please feel free to make-up any missed lesson by attending any other lesson with the age group and time that best fits your schedule.

Download a complete 2012 Emerald Greens Jr Golf brochure here. (.pdf file)

Contact Coach Wallin at:      Barry.Wallin@futuresclub.org      or        cell:  651-245-5899