Junior Assistant Coach Registration

Registration for Junior Assistant Coaches who would like to Volunteer with First Tee - Naples/Collier

Junior Assistant Coach Registration

This registrations is required of all volunteers under the age of 18. Junior Assistant Coach will be referred to as JAC in the registration.

Junior Assistant Coach Information

JAC Name:(Required)

First Last

JAC Email(Required)

JAC Cell Phone(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Gender(Required)

Ethnicity(Required)

Date of Birth(Required)

School:(Required)

Grade

Have you achieved A/B Honor Roll or equivalent anytime during this school year?(Required)

Parent/Guardian Information

Parent/Guardian Name:(Required)

First Last

Relationship to Junior Assistant Coach

Parent/Guardian Email(Required)

Preferred Phone:(Required)

Secondary Phone:

Emergency Contact Name:(Required)

First Last

Relationship to Junior Assistant Coach(Required)

Emergency Contact Preferred Phone(Required)

Emergency Contact Secondary Phone

Health Information

Are there any medical conditions that may have bearing on your participation in The First Tee of Naples/Collier Programs?(Required)

Yes

Please select any that apply:

If you have allergies (such as dust, plants, animals, food, medication) please list: also indicate if you have an EpiPen:

Do you have a disability that may have bearing on their participation in the First Tee - Naples/Collier Program?(Required)

If yes, please explain:

Waivers: Required completion by parent/guardian

Emergency: In the event that I cannot be reached in an emergency, I agree to accept any and all determinations of need for medical assistance and/or administration of medical attention deemed necessary by the First Tee - Naples/Collier representatives. I hereby give permission to the medical personnel selected by the First Tee - Naples/Collier representatives to secure any and all advised hospitalization, medical, dental and/or surgical treatment. In the event that such medical attention is needed from a healthcare provider, all costs shall be the responsibility of the parent or guardian. Parent/Guardian please Initial below:(Required)

MEDIA RELEASE: I hereby give the First Tee - Naples/Collier and participating agencies permission to use any film, video tape, photographs of the above mentioned minor for lawful promotional or informational purpose. Parent/Guardian please initial below:(Required)

EQUIPMENT: I understand that any golf equipment received for use is the property of the First Tee - Naples Collier, and must be returned upon termination of program involvement. Participant & Parent/Guardian please initial below:(Required)

THE FIRST TEE CODE OF CONDUCT The participant and parents or other representatives of participants understand and agree to abide by the rules and regulations set forth in the First Tee Code of Conduct and Nine Core Values. This includes during events as well as written correspondence and electronic social media interactions. If they fail to do so, there are consequences which may include suspension, cancellation of benefits and/or being prohibited from participating in future events hosted by the First Tee - Naples/Collier as well as The First Tee home office. The First Tee - Naples/Collier has absolute discretion in enforcing this policy. Participant & Parent/Guardian please initial below:(Required)

WAIVER I the parent/legal guardian of the above named youth, give approval of participation in the First Tee - Naples/Collier sponsored activities. I understand that the First Tee - Naples/Collier is an independent organization which benefits from the participation of many golf organizations including the First Tee home office and its oversight organizations PGA Tour, PGA of America, USGA, Augusta National Golf Club, and the LPGA. I assume all risks of injury whatsoever and agree to hold harmless the First Tee - Naples/Collier and the First Tee home office including its oversight organizations from claim(s) of any nature arising from any activity, including transportation, connected with the First Tee - Naples/Collier facility or program(s). This hold harmless agreement includes, but is not limited to, any claim due to injury proximately resulting from negligence of the First Tee - Naples/Collier, its employees, agents, LPGA and PGA Professionals, participating agencies, and volunteers. I consent to the First Tee - Naples/Collier communicating information regarding my child’s participation via the internet. Parent & Guardian please type name; Participant please type name.

By virtue of typing your name in the boxes above, this will be considered an electronic signature. Use the + to add a second line for signatures.

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By submitting this registration, you have your requested permission to volunteer with the First Tee – Naples/Collier. Written approval must be given by First Tee – Naples/Collier staff prior to beginning any volunteer activities with First Tee – Naples/Collier and related programs.