For statistical purposes only (optional - you are not required to answer): Which of the following best describes your race or ethnic group?

Participant Information - please print or type - all information is requiredLPGA-USGA Girls Golf of (city, state)

Participant’s Name Address

City State Zip Home Phone ( )

Participant’s Birth Date / / Parent/Guardian Day Phone ( )

School Grade Parent Email

Golfing Experience

Please check the level that best describes your ability:

Do you own your own clubs? Other junior golf affiliation

Level I: New Golfer - Very little or no on-course experience.

Level II: Able to play hole 125 yards from green.

Level III: Average between 65-75 for nine holes on a regulation course.

Level IV: Average between 55-64 for nine holes on a regulation course.

Level V: Play 18 holes with a score of 110 or better on a regulation course.

Level VI: Play 18 holes with a score of 95 or better on a regulation course.

Photo & Press ReleaseI, being Parent/Guardian of ____________________________________________________, hereby consent that any photographs and/or motion pictures or videotape in which my child/ward appears, and any audio recordings made of her voice may be used by LPGA-USGA Girls Golf, its assigns or successors, in whatever way they desire, including television and electronic media; furthermore, I hereby consent that such photographs, films, and recordings, and the plates and/or tapes, from which they are made shall be their property, and they shall have the right to sell, duplicate, reproduce, and make other uses of such photographs, films, recordings, plates, and tapes as they desire free and clear of any claim whatsoever on my part. ___________ (INITIALS OF PARENT/GUARDIAN)

Black or African American WhiteHispanic Other

Name Address City State Zip

Relationship Day Phone Night Phone

Consent & Release - Parent or Guardian MUST sign in space indicated below for application to be considered.Parent/Guardian Statement I, the parent (or guardian) of the participant named above, am familiar with the plans and purposes of LPGA-USGA Girls Golf and give full permission for my child/ward to attend LPGA-USGA Girls Golf events and to participate in all phases of LPGA-USGA Girls Golf activities. I understand that, by signing this Consent & Release Form below, I agree to waive and release any rights and claims for damages against, and hold harmless LPGA-USGA Girls Golf, LPGA, The LPGA Foundation, the USGA, and each of their respective officers, directors, employees, volunteers, workers, members and agents, from and against any and all injuries or damages which may result from or arise out of my child’s/ward’s participation in LPGA-USGA Girls Golf events and activities.

Dispute Resolution In the event of a controversy or claim arising out of or relating to this Participant Form the undersigned hereby agrees to arbitration held in a mutually agreeable location in accordance with the Commercial Arbitration rules of the American Arbitration Association. A judgment rendered by the arbitrators shall be final and nonappealable, and may be entered in any court having jurisdiction thereof.

Medical Emergency Statement I, the parent (or guardian) of the participant, give my permission for my child/ward to receive emergency medical treatment, if necessary, as a result of participation in the LPGA-USGA Girls Golf program. It is understood that every effort will be made to contact me before taking this action.

Release of Participant Person(s) other than parent who may pick up the participant at the end of any LPGA-USGA Girls Golf event:

In Witness Whereof I have read, understand and agree to this entire consent form.

* PARENT/GUARDIAN SIGNATURE REQUIRED

1.20.2012

Asian / Pacific IslanderAlaskan Native / American Indian

DateName

Participant Form

2012 Schedule of Events:

The First Tee of Green Valley Ranch Membership$20Year Long Membership Fee$100

Additional to TFTGVR Registration Fee. Cost includes Membership Kit and participation in all events (except Parent-Daughter Tournament).

Cost includes Membership Kit and participation in all events (except Parent-Daughter Tournament).

Pay Per Event$20$10 Per Event

Cost includes Membership Kit and ability to register for individual events at $10 each.

Check the Membership Applicable:

All individual Instruction Days and Play Days can be registered and paid for online. If you are paying per event, and would like to pay for individual events now, check the events below. If you are a TFTGVR Mem-ber or Year-Long Member and would like to register for individual events now, check the events below:

5/7 5/14 5/21 5/30 6/4 6/11 6/18 6/25 6/28 7/9 7/16 7/30 8/6 8/13 8/20 9/6

Monday Monday Monday Wednesday Monday Monday Monday Monday Thursday Monday Monday Monday Monday Monday Monday Thursday

4:00-5:00 4:00-6:004:00-5:004:00-5:30 4:00-6:004:00-6:004:00-5:004:00-6:007:00-9:004:00-6:004:00-5:004:00-6:004:00-6:00 4:00-5:004:00-6:004:00-5:30

Instruction Day Play Day Instruction Day Colorado Women’s Open Clinic (FREE) Play Day Play Day Instruction Day Play Day Movie Night! Play Day Instruction Day Play Day Parent/Daughter Tournament! Instruction Day Play Day End of Year Party! (FREE)

Please complete the entire application and return with payment to:Colorado Open Golf Foundation ● The First Tee of Green Valley Ranch

20309 E. 48th Pl., Denver, CO 80249 ● Phone (303) 486-8800 ● Fax (303) 486-8823Make Check Payable to: Colorado Open ● A $25 fee will be charged for returned checks

$ Membership Fee $ Events to Pay For - Per Event Membership ONLY (# of classes X $10 = total)

$ TOTAL

LPGA*USGA Girls Golf Green Valley Ranch 2012 Membership Registration

PARTICIPANT AGREEMENT

1. I will respect the environment and the people with whom I come in contact and will try to be sensitive to the needs of each participant in LPGA-USGA Girls Golf.2. I understand that the use of alcohol or illegal drugs will not be tolerated and that usage during any LPGA-USGA Girls Golf event will result in expulsion from both the program and the event.3. I will be responsible for my personal belongings and equipment and will not hold LPGA-USGA Girls Golf, LPGA, The LPGA Foundation, the USGA or their employees responsible for their loss due to my negligence or abuse.4. I will treat the facilities and equipment provided by LPGA-USGA Girls Golf with care. I understand that I will be assessed for any damage to facilities or equipment caused by my negligence or abuse.5. I will use any safety equipment furnished by LPGA-USGA Girls Golf for my own safety.6. I understand that if I am sent home early due to any serious misconduct, it will be at my expense, and LPGA-USGA Girls Golf will make my travel arrangements.7. I will comply with the LPGA-USGA Girls Golf Code of Ethics.

_____________________________________ ____________________________________ ________________ Participant’s Name (Please print) Participant’s Signature Date

_____________________________________ ____________________________________ ________________ Participant’s Parent/Guardian Name (Please print) Participant’s Parent/Guardian Signature Date

THIS AGREEMENT MUST BE SIGNED BY THE PARTICIPANT AND PARTICIPANT'S PARENT/GUARDIAN

LPGA-USGA GIRLS GOLF CODE OF ETHICS

Treat others as you would like to be treated

Replace divots

Rake bunkers and repair ball marks so you leave the course better than you found it

Club throwing, swearing, cheating, littering or smoking are not acceptable

Always thank the host professional

GG6.3.11