Premier Junior Tour - 2010 Membership Form

I hereby agree that any application for membership or tournament application is subject to acceptance by Premier Junior Tour. I also agree
that I am applying for membership or any tournament with the consent of a parent/guardian for all junior divisions. I certify that I am
qualified by the rules of eligibility of Premier Junior Tour and agree to abide by any rules of any event, including the Premier Junior Tour
Code of Conduct and Pace of Play system. I understand and agree that membership is non-refundable once submitted. I understand and
agree that any tournament entry fee is non-refundable, and credits are as given as specified under Tour Rules. I agree that Premier Junior
Tour may use my name and likeness for publicity and promotional purposes under NCAA and USGA guidelines. I acknowledge and agree
that Premier Junior Tour photos, of which I may be a part, may be available for purchase by emailing Premier Junior Tour. I hereby release
the host facility, Premier Junior Tour, its officers, directors, employees, volunteers, any and all Sponsors, and all of each company's
respective officers, employees, volunteers and affiliates from any and all liability for any event or consequence arising out of or relating to
members' participation in a Premier Junior Tour event with the sole and singular exception of liability arising out of bad faith or willful
misconduct. I agree that there are certain risks inherent in the game of golf and accept personal and sole liability for all such risks and
damage incurred in conjunction with a Premier Junior Tour tournament or qualifier for the participant as well as any and all spectators.
Examples include, but are not limited to: any health-related or safety issues and damage to the golf course, private property, host hotel or
other event-related venues. In case of emergency during a Premier Junior Tour tournament, I, as the parent and/or guardian of the
tournament participant (and myself in the case of amateur division participants), authorize a qualified medical doctor or any emergency
care personnel to take all necessary measures in the treatment of the aforementioned tournament participant. I understand Premier Junior
Tour may update these terms and conditions periodically and that the latest revision will be posted to www.premierjuniortour.com.

     By clicking submit below I/we (participant, parent/guardian) confirm I/we have read and agree to Premier Junior Tour "Tour Rules",
Spectator Conduct and Rules, Player Code of Conduct, and Pace Of Play. I agree to keep apprised of my responsibilities by reviewing Tour
Rules for any changes before a tournament.

Player's Name:

Address:

City, State, Zip, Country:

Birthday
(mm/dd/yyyy):

Gender
(Male or Female):

Specify 2010 Division
Amateur Div (Men or Women up to age 25);
Men16-19, M13-15, YMen11-12,Boys9-10,
B7-8*, B6&U*; Women 16-19, W13-15,
YW10-12, Girls 8-9*, G7&U*
* = 9 hole/day divisions

HS Grad Year (or grade you enter Fall 2010):

Parent(s)/Guardian(s) Name(s):

Home Phone #:

Cell Phone #'s:

Average Score (for 18 hole/day divisions):

Average Score (for 9 hole/day divisions):

Email is our primary method of contact
with you. Please provide all email
addresses you would like to have receive
weekly communications sent to.:

Important: How did you hear about us?

Name of your newspaper:

Golf Club you belong to or play at:

Name of School you attend:

Hobbies:

EQUIPMENT: Driver:

Woods:

Irons:

Wedges:

Putter:

Ball:

Glove:

PREMIER JUNIOR TOUR 2010 MEMBERSHIP FORM