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Is the applicant on an IEP?*
Is the applicant being seen by a professional for emotional concerns?*
We require two (2) contacts in case of emergency.
Emergency Content 1
Relationship to participant:*
Emergency Content 2
Registration Form Completed By:*
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 program representatives. I hereby give permission to the medical personnel selected
by program representation to secure any and all medical, hospitalization, dental, and/or surgical treatment. In event that such medical
attention is needed from a healthcare provider, all costs shall be the responsibility of the parent or guardian.
Signature:* (Use your mouse to draw your signature in the box below.)
I hereby give Hyport, Headquarters Office and participating agencies permission to use film, videotape and/or photographs of the above-
mentioned minor for lawful promotional or informational purposes.
The undersigned parent or guardian of , a minor, does hereby consent to his/her participation in the voluntary golf program at Twin Brooks Golf Club. I do forever RELEASE, acquit, discharge, and covenant to hold harmless the Twin Brooks Golf Club, Hyport Associates, Resort and Conference Center at Hyannis, Donnellan Golf, Coastal Golf Management and its successors, departments, officers, employees, servants and agent, of and from any and all actions, causes of action, claims, demands, damages, costs, loss of services, expenses and compensation on account of, or in any way growing out of, directly or indirectly, all known and unknown personal injuries or property damage which l may now or hereafter have as the parent or guardian of said minor, and also all claims or right of action for damages which said minor has or hereafter may acquire, either before or after he/she has reached his/her majority resulting or to result from his/her participation in the Twin Brooks Golf Club golf program; FURTHERMORE, l hereby agree to protect Twin Brooks Golf Club and its successors, departments, officers, employees, servants and agents against any claim for damages, compensation or otherwise on the part of said minor growing out of or resulting from injury to said minor in connection with his/her participation in the Twin Brooks Golf Club's voluntary activities or programs, and to INDEMNIFY, reimburse or make good to the Twin Brooks Golf Club, Hyport Associates, Resort & Conference Center at Hyannis, Donnellan Golf, Coastal Golf Management or its successors, departments, officers, employees, servants and agents any loss or damage or costs, including attorneys' fees, the Twin Brooks Golf Club or its representatives may have to pay if any litigation arises from said minor's participation in said recreation program.
Who can pick up your child? (In addition to the parents/legal guardians, what other adults are authorized to pick up your child from Twin Brooks Golf Club?
These adults must show a photo ID to pick up your child. Please call 508 862 6980 for same day substitution.
Authorized Pick-Up 1
Relationship to participant:
Authorized Pick-Up 2
In order to be enrolled a Parent/Guardian must agree to attend a brief meeting on Wednesday, June 27th, 2018 at 7PM at the Twin Brooks Golf Course Pro Shop where the Community Youth Program will be explained.
Parent / Guardian Signature:* (Use your mouse to draw your signature in the box below.)
“As a business consultant, it’s refreshing to observe such a “tight ship” being run by such a young staff. Not only are they on the ball, but they are always friendly.”
Joe Manning, Owner; Act Big Business Consulting
35 Scudder Ave.Hyannis, MA 02601508.862.6980 [email protected]