The First Tee of San Juan County, NM

The First Tee of San Juan County, NM

Description of Programming Levels

PLAYer:Participants that are new to the program begin at the PLAYer level.

(Min. Age 6)This course offers an introduction into the Nine Core Values and gives participants the basic fundamentals of the golf swing and incorporates other popular activities in with golf to make the participant comfortable in learning the game. Participants must pass the PLAYer assessment to move into PAR level.

PAR:Participants that have passed the PLAYer level assessment move into PAR level

(Min. Age 9)programs. At this level, participants learn interpersonal communication skills, the importance of a good attitude, dealing with emotions and focusing on doing the best that you can without worrying about what others are doing. Golf skills continue to focus on fundamentals with more opportunities to access the golf course to play. Participants must pass the PAR assessment to move into BIRDIE level.

BIRDIE:Participants that have passed the PAR level assessment move into BIRDIE level

(Min. Age 11)programs. At this level, participants learn the importance of setting goals, practicing goal ladders and decision making using S.T.A.R. Golf skills progress into advanced levels and golf course management is talked about daily. Participants will be on the golf course playing more than half of the classes. Participants must pass the BIRDIE assessment to move into EAGLE level.

EAGLE:Participants that have passed the BIRDIE level assessment move into EAGLE level

(Min. Age 13)programs. At this level, participants focus on physical and mental wellness, appreciating diversity, building GO-TO teams and being a GO-TO person as well. EAGLE level also encourages participants to start thinking about life after high school and helps with national scholarships and opportunities within the organization. EAGLE level participants must complete a minimum of 50 hours of community service and to pass the EAGLE level assessment to move into ACE.

The First Tee of San Juan County, NM

2017Riverview GC SummerSession #2

Registration Form

Name:______Birthdate:______Age: _____ Grade Level: ______

Address:______City/Zip: ______

Gender:M FSchool: ______

Name of Parent/Guardian:______

Home Phone #:( ) ______- ______Cell Phone #:( ) ______- ______

Email (required):______

Does participanthave a set of golf clubs? YN Is your child Right or Left Handed? _____

What Level is your child signing up for?

*If you are having difficulty affording the programming fees, please contact The First Tee Office at 334-4291.

Summer Session #2: July 11, 13, 18, 19, 20, 24, 25, 26, 27, 31, August 1, 3

PLAYer Class:8-9:15 AM

PAR Class: 9:45 – 11:00 AM (only if participant has passed PLAYer class into PAR)

BIRDIE/EAGLE Class: 11:30 AM – 1:00 PM (only if participant has passed PAR or BIRDIE)

AMBASSADOR DONATION:While programming rates remain low, the costs per participant keep increasing. Currently our costs exceed $100 per participant for programming. We also provide programs at no cost for participants that cannot afford the registration fee. If you would like to donate to the program, or provide a scholarship, please circle a donation option below and send amount with registration. All donations are tax deductible through our IRS 501(c)3 foundation. (Please see attached form)

Ambassador: $50 Couple Ambassador: $100

Other amount donated: ______I do not wish to donate at this time: ______

Signature of Parent/Guardian:______

Send Registration Form, Permission Form and Payment ($75+ donation) To:

The First Tee of San Juan County, NM

PO Box 360

Kirtland, NM 87417

(505) 334-4291

Or pay with Paypal online: Send payment via Paypal to:

Date Paid: ______Amount Paid: $______

Payment Method: CASHCASHIERS CHECKPERSONAL CHECK**PAYPAL

**A $25.00 Fee will be assessed for any returned check

The First Tee of San Juan County, NM

Participant Permission Form

(Past participants do not need to fill this form out again, unless information has changed)

Today’s Date: ___/____/2017

Participation: ____New ___Return …………………………………………………………………………………………………………………………………………..

Youth Information (All fields required / Please print clearly)

Name: ______Gender : Female Male

(First, Last)

Address: ______City: ______State: ____ Zip Code:______

Ethnicity: African-American Asian-American Caucasian Hispanic Native-American Pacific Islander Other Don’t wishto respond

Birth Date: (_____/_____/_____) School: ______Grade Level: ______

Health Concerns: ______Disability Information: ______

Parent/Legal Guardian: ______Relationship______

(First, Last)

E-mail (Required): ______Phone:(home)______(cell)______

Family Income(please circle one):

Below $10,000 $10,000-$24,999 $25,000-$49,999 $50,000-$74,999 $75,000-$100,000 Above $100,000 Do not wish to respond

Participation Consent Form completed by: Mother Father Legal Guardian

………………………………………………………………………………………………………………………………………………

Health Information

Emergency Contact: ______Relationship:______

(if parent/guardian cannot be reached)

Work Place:______Phone:______

In the event that I cannot be reached in an emergency, I agree to accept any and all determinations of need for medical assistance and/or administration of medical attention deemed necessary by The First Tee of San Juan County, NM representatives. I hereby give permission to the medical personnel selected by The First Tee of San Juan County, NM representatives to secure any and all medical, hospitalization, dental, and/or surgical treatment. In event that such medical attention is needed from a healthcare provider, all costs shall be the responsibility of the parent or guardian.

Parent/Guardian Initials: ______

………………………………………………………………………………………………………………………………………………..

Equipment

I understand that any golf equipment received for use is the property of The First Tee of San Juan County, NM, and will be returned at the discretion of The First Tee of San Juan County, NM upon the termination of the participant’s involvement in the program.

Parent/Guardian Initials: ______

………………………………………………………………………………………………………………………………………………..

Media Release

I hereby give The First Tee of San Juan County, NM, Headquarters Office and participating agencies permission to use film, video tape and/or photographs of the above mentioned minor for lawful promotional or informational purposes.

Parent/Guardian Initials: ______

………………………………………………………………………………………………………………………………………………..

I, the parent/legal guardian of the above named youth, give approval for participation in The First Tee sponsored activities. I assume all risks of injury whatsoever and agree to hold harmless The First Tee of San Juan County, NM and Headquarters Office from claim(s) of any nature arising from any activity, including transportation, connected with The First Tee facility or program. This hold harmless agreement includes, but is not limited to, any claim due to injury proximately resulting from negligence of The First Tee of San Juan County, NM or Headquarters Office, its employees, agents, LPGA and PGA Professionals, participating agencies, and volunteers. I consent to The First Tee of San Juan County, NM and Headquarters Office communicating information regarding my child’s participation via the internet.

Parent/Guardian Signature:______Date:______

Please Print Name: ______

Staff Signature:______Date:______