Member must meet the program requirements for enrollment. A probationary period of 60 days is required. Dues are non-refundable. All applications for membership are contingent upon acceptance by the Executive Director of the Roaring Lambs International Junior Golf Academy.

For additional information contact Ms. Gladys Lee at (214) 339-4423.

The following forms must be completed for membership consideration.  Forms

may be completed and submitted on line; or printed using the Adobe link and mailed to .

Ms. Gladys Lee

Roaring Lambs International Junior Golf Academy

2515 Perryton #2316

Dallas, TX  75233

 

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Membership Application

 

Member Information

Member Name:

Date of birth:

Age:

Sex:           Female     Male

Current address:

City:

State:

ZIP Code:

School Attending:

Current Grade Level: 

Race (optional):  African-American   Caucasian   Hispanic   Asian    Native-American Other

Parent/legal guardian Information

Parent / Legal Guardian:

Current address:

Relationship:

Phone:

Cell:

Email:

City:

State:

ZIP Code:

Spouse Information

Name:

Phone:

Cell Phone:

Email:

Emergency Contact

Name of a relative not residing with you:

Address:

Phone:

City:

State:

ZIP Code:

Relationship:

Consent

I/We give permission for my child to participate all Roaring Lambs International Junior Golf Academy activities. I release Roaring Lambs International Junior Golf Academy and individuals from liability in case off accident during activities related to Roaring Lambs International Junior Golf Academy, and agree to hold harmless Roaring Lambs International Junior Golf Academy from claims of any nature arising from any activity, including transportation connected with Roaring Lambs International Junior Golf Academy.  This hold harmless agreement includes, but is not limited to any claim due to injury resulting from negligence of Roaring Lambs International Junior Golf Academy, its employees, agents, PGA and LPGA professionals, participating agencies and volunteers.

 

I/We authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the even that neither parent/guardian can be reached in the case of an emergency.  In the event I/We cannot be reached, I/We agree to accept all determinations of need for medical assistance and/or administration of medical attention deemed necessary by Roaring Lambs International Junior Golf Academy representatives.  I hereby give permission to the medical personnel selected by Roaring Lambs International Junior Golf Academy representatives to secure any and all advised medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures.   In the event that such medical attention is needed, all costs of such care shall be borne by the parent(s) or guardian(s).

 

I/We hereby give Roaring Lambs International Junior Golf Academy and participating agencies permission to use any film, videotape or photographs of the above mentioned minor for lawful promotion or informational purposes ONLY.

 

Trip coordinators will accompany all children and plan their activities.  All participating children are expected to take direction from the coordinators only.  Any parent/guardian that chooses to go with their child on the planned activities must, also, accept the authority of the coordinators and shall not engage their child in activities other than what has been planned by the coordinators, unless prior arrangements have been clearly made in detail with the coordinators.

 

Signatures

Signature of Parent/Legal Guardian:

Date: 

Signature of spouse:

Date: 

         

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Roaring Lambs

 

 

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Roaring Lambs International Global Fairway Seekers

Adult Membership

 

Membership is valid for one year from the date of purchase and is not transferable.  Membership benefits include:

 

  • Membership Card

  • Ghin Handicaps

  • Western States Golf Membership

  • Roaring Lambs International Events Discount

 

For questions regarding you member benefits call our Membership Office at (214) 339-4423 or (214) 212-9475.

 

Adult Membership Application

 

Membership Type:     New     Renewal              Member since:

Last Name:

 

First Name:

 

Company:

Title:

 

Address:

 

City:

 

State:

 

Zip Code:

 

Telephone:

 

Work Phone:

 

Cell :

 

Email:

 

Pay by:

Check          Money Order

Signature:

 

Date:

 

 

Text Box: Make Checks Payable To:  Roaring Lambs International   Mail of Fax form to:   Roaring Lambs International                                   2515 Perryton Drive, #2316                                   Dallas, TX  75233  

 

 

 

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Member Emergency Contact and Medical Information

 

Member Name: 

Female

Male

 

Date of Birth: 

 

 

 

Parent’s/Guardian’s Name: 

Parent’s/Guardian’s Name: 

 

Home Phone: 

Home Phone: 

 

Work Phone: 

Work Phone: 

 

Address: 

Address: 

 

City, ST  ZIP Code: 

City, ST  ZIP Code: 

 

Alternative Emergency Contacts

 

Primary Contact: 

Secondary Contact:  

 

Home Phone: 

Home Phone: 

 
Work Phone: Work Phone:

Address: 

Address:

 

City, ST  ZIP Code: 

City, ST  ZIP Code: 

 

Medical Information

 

Hospital/Clinic Preference: 

 

Physician’s Name: 

 

Phone Number: 

 

Insurance Company: 

 

Policy Number: 

 

Please check ALL that apply:   Asthma     Diabetes     Epilepsy     Allergies     Please Explain:

 

Special Health Considerations: 

 

 

I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the even that neither parent/guardian can be reached in the case of an emergency.  In the event I/We cannot be reached, I/We agree to accept all determinations of need for medical assistance and/or administration of medical attention deemed necessary by Roaring Lambs International Junior Golf Academy representatives.  I hereby give permission to the medical personnel selected by Roaring Lambs International Junior Golf Academy representatives to secure any and all advised medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures.   In the event that such medical attention is needed, all costs of such care shall be borne by the parents or guardians.

 

 

Parent’s/Guardian’s

Signature: 

 Date: 

Parent’s/Guardian’s

Signature: 

Date: 

 

 

I give permission for my child to participate all Roaring Lambs International Junior Golf Academy activities. I release Roaring Lambs International Junior Golf Academy and individuals from liability in case off accident during activities related to Roaring Lambs International Junior Golf Academy, and agree to hold harmless Roaring Lambs International Junior Golf Academy from claims of any nature arising from any activity, including transportation connected with Roaring Lambs International Junior Golf Academy.  This hold harmless agreement includes, but is not limited to any claim due to injury resulting from negligence of Roaring Lambs International Junior Golf Academy, its employees, agents, PGA and LPGA professionals, participating agencies and volunteers.

 

 

Parent’s/Guardian’s

Signature: 

Date: 

 

Parent’s/Guardian’s

Signature: 

Date: 

 

 

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Parent Release Form for Media Recording

I, the undersigned, do hereby grant or deny permission to Roaring Lambs International Junior Golf Academy to use the image of my child, , as marked by my selection(s) below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Roaring Lambs International Junior Golf Academy Web site.

  Deny permission to use my child’s image at all.

  Grant permission to use my child’s image in the following ways (mark all that apply):

Limited usage:  I want my child’s image used within the Roaring Lambs International Junior Golf Academy

     setting only (not in the larger community).

Limited usage:  I want my child’s image used for educational materials only (not marketing).  This could be

     either within Roaring Lambs International Junior Golf Academy or in the larger community.  One example of

     this could be videos in parent education classes.

Limited usage:  I want my child’s image used on printed materials only (no digital or video use).

Unrestricted usage:  I give unrestricted permission for my child’s image to be used in print, video, and

     digital media.  I agree that these images may be used by Roaring Lambs International Junior Golf Academy

     for a variety of purposes and that these images may be used without further notifying me.

Parent/guardian signature:       Date: 

Please make a copy of this form for your own records and mail or fax the original to:

Gladys Lee

Roaring Lambs International Junior Golf Academy

2515 Perryton, #2316

Dallas, TX  75233

Email:  RoaringLambs@sbcglobal.net

If you have questions, contact Ms. Gladys Lee at (214) 339-4423.

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