WHY. Search Blue Mash Golf Camp on YouTube to view fun videos of the past years of Summer Camp!

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2 WHY? The Areas Best Practice Facility- Blue Mash has the area s most immaculate and incredible practice facility featuring an all grass driving range tee. Your campers will receive instruction at our 10,000 square foot putting green, short game green with practice bunkers, as well as our newly finished Bermuda grass driving range. Teacher to Student Ratio- Learning in a group is super fun, but honing in on individual strengths and weaknesses is important for improving golf skills. Our camp staff provides quality one on one time with each camper. The max student to teacher ratio is 6:1 at Blue Mash. Lunch Included- Don t worry about packing food for your campers. Full and half day campers will enjoy lunch from the Blue Mash Grill. Fountain drinks will be included for them and snacks can be purchased separately. Daily On Course Practice What good is it to attend golf camp if you can t get out there and experience the real thing as often as possible? Learning to play wooded holes and open fairways, avoiding water, mastering tricky sand shots, seeing how to read a green- it s all valuable, it s all interesting, and it s all available at Blue Mash Golf Camp! Points & Prizes Throughout the week, each camper has the opportunity to earn points for winning contests, knowing trivia, showing improvement as well as keeping a positive attitude. Points earned can be used to win prizes at the end of camp. Search Blue Mash Golf Camp on YouTube to view fun videos of the past years of Summer Camp!

3 General Information- Page 1 of 3 Instructions: Please fill out for 1 camper only. CAMPER S INFORMATION Camper s Name: Male Female DOB: / / Age at time of camp: Grade in Sept. 2017: Returning Camper New Camper Does camper have his or her own clubs? Right or Left Handed? Friend to be grouped with (we ll do our best) Shirt Size: FAMILY INFORMATION Parent Name(s): Home Street Address: City: State: Zip: Cell Phone: Home Phone: Work Phone: HOW DID YOU HEAR ABOUT BLUE MASH GOLF CAMP? Blue Mash website Route 108 Banner Friend Friend s Name: Blue Mash Blast Other (please specify)

4 Session Dates and Payment Information- Page 2 of 3 Instructions: Place an X in the desired sessions. Only fill out Payment Information if mailing this form to Blue Mash. Rates are per 1 camper/1 session. CAMP RATES & TIMES Beginner = $275 9:00 AM to 12:30 PM (lunch included) Intermediate = $450 9:00 AM to 3:00 PM (lunch included) Advanced = $500 9:00 AM to 3:00 PM (lunch included) SESSION DATES Choose desired session(s): Half Day Full Day Full Day # 1 Starts June 19 # 2 Starts June 26 # 3 Starts July 10 # 4 Starts July 17 # 5 Starts July 24 # 6 Starts July 31 # 7 Starts August 7 # 8 Starts August 14 # 9 Starts August 21 PAYMENT INFORMATION Number of Beginner Sessions: Number of Intermediate $275 $450 = Number of Advanced $500 = Total $ Payment Type (Circle One) Visa Mastercard Amex Check Cash Name on Card: Credit Card Number Expiration Date: / Check #: Billing Zip: Date: / / SKILL LEVEL GUIDE Refund Policy Refunds are available, minus a $50 cancellation fee, if enrollment is not cancelled at least two weeks before camp. There will be no refund or prorated tuition for campers arriving late or leaving early in the session for which they are enrolled. All refund requests must be submitted in writing via and must receive written confirmation from Blue Mash in order to be processed. General Matters I agree that Blue Mash Golf Course is not responsible for the loss or damage to my child s personal belongings as a result of fire, theft, laundry, gophers, etc. I agree to accept full responsibility, financial or otherwise, for the conduct of my child. In order to make each camper s participation at Blue Mash Golf Course a fun, safe and re- warding experience, we hold high expectations for camper attitude and behavior. I understand that there is no refund should my child be dismissed from camp for behavior or conduct deemed unsatisfactory by the camp directors or if, in the sole opinion of the camp directors, a camper s presence is not in the best interest of the camp. All pictures taken at or in connection with Blue Mash Golf Course are the sole and exclusive property of Blue Mash Golf Course and may be used by Blue Mash in any camp promotional materials and other print media for camp purposes. Beginner (Mon - Thu Half Day): For students who have not played before, or have a very limited amount of skills. Recommended for camper ages Intermediate (Mon Fri Full Day): For students who have some prior golf experience. They must show a desire to improve their game. Prior course play is not necessary to join this camp but they should have the stamina to carry their bag for 9 holes. Advanced (Mon Fri Full Day): For juniors looking to bring their game to a competitive level. They have solid and consistent ball striking, are able to play a variety of different shots around the greens, and have played 18 holes unsupervised before. Must be able to carry own golf bag for the entire week.

5 Medical Information and Permission to Treat- Page 3 of 3 Instructions: This page must be completed in full for camper to attend camp. Fill out a separate page for each camper. Date of most recent tetanus (or DPT) immunization (required by law): A copy of an immunization record is required for campers/students who attend a school outside the State of Maryland or who have not yet been enrolled in a Maryland School. If immunizations are contraindicated, a written statement must be provided. Primary care physician: Phone: Pertinent information on any health conditions including physical, psychiatric or behavioral: Allergies: Will prescription medications need to be administered to our student during camp hours? Yes No Emergency Contact, when a parent/guardian is unavailable: Name: Relationship: Home Phone: Cell: Work Phone: I request and authorize Blue Mash Golf Camp s staff to administer first aid and/or take my child to a physician or hospital for emergency treatment in the event it appears necessary and a parent or guardian cannot be contacted in a timely manner, as Blue Mash deems appropriate under the circumstances. I give to any physician, dentist, hospital, or other health care provider consent to perform any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment, under the supervision of any licensed physician or dentist. I agree that I will be financially responsible for the costs of such treatment and transportation. Informed Consent In exchange for Blue Mash permitting my child to participate in Blue Mash Golf Camp, I agree to the terms and conditions expressed herein. While Blue Mash will make every reasonable effort to keep all students safe from injury, illness, and harm, accidents do happen. I understand that there may be risks associated with the camp, and have had an opportunity to ask questions and to receive answers concerning those risks. I acknowledge that it is my responsibility to evaluate the risks associated with my child s participation in this camp to determine whether my child should participate, and to discuss these risks with my child. By signing this document, I agree to release and hold harmless Blue Mash, its officers, trustees, agents, employees, volunteers, and leaders/chaperones, and agree to indemnify each of them from any and all claims, costs, suits, actions, judgments, and expenses, upon any damage, loss or injury to my child or damage or loss to my child s property (including all property of others in my child s possession or control) arising out of my child s participation. These agreements of release and indemnity include claims of negligence, but not of gross negligence or intentionally wrongful conduct. X Date: / / 20 Parent/Guardian Signature & Date My signature verifies that all submitted information is correct and that I understand & agree to all waivers.