NAME:____________________________________________________________

ADDRESS:_________________________________________________________________
                     ________________________________________________________________

PHONE:_____________________

EMAIL ADDRESS:________________________

BIRTHDAY: AGE ON JULY 7:______________

PARENT OR GUARDIAN NAME:__________________________________

CHECK HERE IF PLAYING IN TOURNAMENTS ONLY (NOT CLINICS)_____

CHOOSE A CLINIC:

BOYS 10 AND UP_______JUNE 14-17

ALL GIRLS/BOYS 9 AND UNDER_______JUNE 21-24

1-FIRST CHOICE, 2-SECOND CHOICE, 3-THIRD CHOICE

____ 4 day clinic 8-9 am

____ 4 day clinic 9-10 am

____ 4 day clinic 10-11 am

____ 4 day clinic 11-12 pm

____ 4 day clinic *12-1 pm

____ 4 day clinic *1-2 pm

____ 4 day clinic *3-4 pm
* if needed

$125.00 PER JUNIOR
(US Kids clinics and tournaments throughout the year are an additional fee)

Please send a check to:
                                                   DeBenedetti Golf Shop, attn: Juniors
                                                   917 Clubhouse Drive,
                                                   Livermore, CA 94551