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Home
Development Phases
Private Coaching
Facility
Camps
Advice
Register
Store

REGISTRATION FORM

Child's Full Name*

Child's Date of Birth*

Parent's Name*

Mailing Address*

Phone Number*

Email*

Emergency Contact Name, Relationship to Child, and Phone Number*

Does Your Child Have Any Health Issues to Be Aware Of?

Is Your Child Left or Right Side Dominant?

What Other Sports Does Your Child Participate In?

Have Your Child Rate Their Own Desire for Playing Golf From 1 (Low) to 10 (High)

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6601 S 84th St, Lincoln, NE 68516

Pine Lake Junior Golf Academy

6601 S 84th St, Lincoln, NE 68516

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