Player Name: _______________________________________ Address_______________________________________________ 

Age (as of 6/1/23) ______ Gender _____ Average 18-hole score _____ or 9-hole score _____ estimated score ____ 

Parents/Guardian_____________________________________________ Cell phone (_____)______________________ 

Best Email: ___________________________________________ Any Health Issues? ________________________________

We will miss these event(s): (circle applicable) ~ 6/11 ~ 6/18 ~ 6/24 ~ 7/1 ~ 7/2 ~ 7/8 ~ 7/9 ~ 7/15 ~ 7/24 

Player signature: ____________________________ Parent/Guardian signature: ___________________________ 

Please make Checks payable to Ed Reely, mail to address below. 

You can use this link to register https://ereely.wufoo.com/forms/fcjgt-registration

Hold Harmless Agreement

 We understand The Franklin County Junior Golf Tour, its director, employees, volunteers, golf course owners, or employees cannot be held liable for any damage or injuries suffered while participating in or traveling to or from a Franklin County Junior Golf Tour event. We also agree to abide by all rules and policies set forth by the Franklin County Junior Golf Tour. Initial: ______ Contact: Ed Reely – P.O. Box 139, Rouzerville Pa. 17250 – C:717-377-2672 – E: FCJGT22@gmail.com