Application to Participate Student Name: Male / Female Age: Student Phone: Date of Birth: Please Circle the Proper Shirt Size: Boys: XS S M L XL Girls: XS S M L XL Mens: XS S M L XL Women s: XS S M L XL Please place an * below next to the parent(s) who would like to be included on the Academy communication list. All e-mails will be blind copied so your e-mail is not at risk of public display. All information is for Academy use only. Mother s Name Phone # E-mail Address Father s Name Phone # E-mail Address Participation in the Napa Valley Junior Golf Academy requires the ability to swing a golf club and participate in fitness activities. Additionally, participation requires the capacity to understand and abide by the rules of the game. Does your child have any current condition that limits his/ her ability to participate in this activity? Yes / No If yes, please explain and identify any modification that would enable your child to participate. I, the parent/ guardian of the above named, apply for a position for my son/ daughter at the Silverado Junior Golf Academy. I hereby give my approval to allow participation in all Academy activities, including golf cart transportation. I know that participation in the Academy may result in serious injuries and hereby waive, release, absolve, indemnify, and agree to hold harmless, Silverado Junior Golf Academy, the owner, organizers, instructors, sponsors, volu nteers and students, for any claim arising out of any injury to my child whether the result of negligence or for any other cause. Parent or Guardian Signature: Date:
Medical Release Form Student s Name: Date of Birth: Parent or Guardian authorization: In case of emergency, if family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel. (i.e. EMT, First Responder, E.R. Physician) Family Physician: Phone: Address: Hospital Preference: In case of emergency contact: Name Phone (#s) Relationship to Student Name Phone(#s) Relationship to Student Please list any allergies and/or medical problems, including those requiring maintenance medication. (i.e. Diabetic, Asthma, Seizure Disorder, Bee sting allergy) Medical Diagnosis Medication Dosage Frequency of Dosage The purpose of the above information is to notify emergency medical personnel of any medical problem which may interfere or alter treatment. Date or Year of last Tetanus Toxoid Booster: Authorized Parent/Guardian Signature: Please Print Name Clearly:
Code of Conduct (Signature required when applying for any Academy Program) The Silverado Junior Golf Academy is proud to have your participation to facilitate the best Junior Golf program in the Napa Valley. It is required that all students adhere to the Code of Conduct while particip ating in a match, practicing and playing at Silverado Resort or elsewhere while representing the Silverado Junior Academy. 1. Attire: When you arrive to the course you are expected to be in proper golf attire: collared shirt, hat, shorts or pants, clean shoes, clean shaven, hair combed etc. Athletic shoes may be worn in replacement of golf shoes. Hats will be worn with the bill forward at all times (no flat bills). Earrings and visible piercings are prohibited on male students. Female students may have visible piercings on ears only. Skirts okay, no short-shorts. 2. Etiquette and Behavior: Introductions when you get to Silverado Resort are imperative. Stand tall, look people in the eye and introduce yourself using a firm handshake and state your name clearly, you are a representative of the Silverado Junior Golf Academy. We expect smiles and the ability to walk confidently on the golf course. Our ownership and members are the reason we are able to run such a vast junior program. They deserve our than ks and respect. If you see one of them, always give the right of way and greet them with a smile. 3. Attitude: Our philosophy is to have a great attitude daily, on or off the course. Although golf at times may be frustrating, it does not give anybody the right to use foul language, disrespect teammates, opponents, coaches, volunteers, golf professionals, parents and anyone else associated with the program. You are required to maintain the golf course and keep it in the best shape possible. Any vandalism, including deep divots and/ or litter is not acceptable. Requirements on the golf course are as follows: replace every divot, repair every ball mark you can, rake the bunker every time you use it and be considerate and supportive of your teammates and opponents. Our goal is to set the standard for exemplary etiquette at all times. 4. Phone use and Social Media: Absolutely NO Social media including videos or pictures are allowed at Academy at any time. Juniors may use their phones to call or answer calls from parental units ONLY. This is a strict policy as it is our responsibility to create a safe learning environment for all jun iors. If anyone is taking video or pictures of themselves or any other juniors during Academy time, they will be required to delete all media and asked to leave Academy. 5. Academy is not to be used as Childcare: Our Academy juniors are here to learn and deserve a safe learning environment where skills can be practiced and developed, both when an instructor is present and when not. Individual practice and play-based learning is part of our development philosophy. All Juniors are entrusted with their own responsible behavior. Our expectations are very high in all aspects and it is unfair to other students learning to monopolize the time of instructors due to poor behavior. If learning cannot be accomplished safely and responsibly, juniors will be asked to leave Academy permanently. Instructors reserve the right to dismiss individuals from Academy at any time. 6. Attitude: Bring your best attitude every day!
Code of Conduct Keep the detailed Code of Conduct Page for your reference and sign below. By signing this code of conduct you are indicating the desire to keep the game of golf a great game and to abide by and accept this Code of Conduct. I understand that any breach of this Code of Conduct may result in termination from the program without a refund. Signature Print Name Parent/ Guard ian Signature Print N am e
Please Mail or Drop Off Applications to: Silverado Junior Golf Academy c/o: Golf Shop - Tara 1600 Atlas Peak Road Napa, California 94558 Or E-mail PDF To: tfox@troon.com All questions should be directed to Tara Fox (707-257-5463 or tfox@troon.com) Please indicate which program you are interested in for your son/ daughter on the bottom of this form. Please include payment to be processed with application. Payment may be made w ith cash, check or credit card (fill out below). Any e-mail sent from the Academy will have Academy in the subject line. Any other e-mails should be deleted Please follow the SilveradoJrGolfAcademy page on Facebook for all communication We also have an online calendar at www.silveradoresort.com under the Junior Golf Academy that is updated monthly. Golf Shop may also be called to check on class cancellations due to weather or Holidays 707-257-5460 ----------------------------------------------------------------------------------------------------------------------------------------------- Annual Registration: $45 Circle One Payment: Member # Cash Check Credit Card (Fill out information below) Payment by Credit Card: Name on Card: Card Type (circle one): Visa MasterCard Discover AmEx Credit Card #: Exp. Date Amount to be Charged: $ Signature: Monthly $99 gift card will be billed at the beginning of each month and used throughout the month. Players Academy $149 will be billed the first week of each month. Choose one or more Programs: Player s Academy $149/month Tuesday,Wednesday(instructional day) &Thurs 3:30-5:30 Tuesday Girls Academy $99/month 3:30-5:00 Tuesday Junior Boys and Girls Academy $99/month 3:30-5:00 Thursday Little Novice $99/Month 3:30-4:15 Wednesday Add Kids4Golf 2018 Youth Tour (6 week summer tournament package) $249.