| 29th Boys ChampionshipJun 14, 2005Hill Crest Country Club | |  |
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Parental Consent Required |
| Detail: |
Before an online entry can be accepted, a signed copy of the parental consent must be recieved by the WPGA.
The following may be printed, signed by the a parent or guardian and mailed or faxed to the WPGA at:
Western Pennyslvania Golf Association
324 Fourth St
Pittsburgh, PA 15238
FAX: 412-826-2183
As parent or guardian of ________________, I hereby certify that I am familiar with his plans to participate in the WPGA Boys Championship and that he does so with my approval and consent. In case of medical emergencyoccurring during this Championship, I authorize a qualified medical doctor to take all necessary measures in the treatment of this applicant.
Relation: ______________________
Signature: _____________________ |
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