* Email

* Child's First Name

* Child's Last Name

Child's Grade Level for the 2025-2026 school year

* Child's Age

* Parent's First Name

* Parent's Last Name

* Parent/Guardian Phone Number

* Guardian who will be signing the child in and out of clinic

* Does the child have any medical conditions or allergies?

* Emergency Contact Name

* Emergency Contact Phone Number

* Please enter your name in the box below to consent to the below: I have read and understand the waiver form listed at www.68venturesbowl.com and give consent for the listed participants in the 68 Ventures Bowl golf clinic at Top Golf Mobile. (Signed waivers are required to play. To download a waiver visit www.68venturesbowl.com).