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Jr Tour 2011


        2011 Parental Consent Form


The applicant and the parent/guardian certify: 1) that the applicant is an amateur player, as defined by the USGA; 2) that the conditions of entry have been read and understood and approval has been granted in submitting his/her entry; 3) the applicant agrees to abide by all the rules and regulations PGA Junior Tour; and 4) that the information given in this application is true to the best of his/her knowledge.


In consideration of the applicant's participation in The PGA Section tournaments : 1) the applicant and the parent/guardian hereby release The PGA of America, The Central Counties PGA, The host sites of PGA Section events and all of each company's respective officers, directors, employees, agents, subsidiaries and affiliates from any and all liability associated either with acts or omissions of such parties, or with accidents or injuries sustained by the applicant or parent/guardian in connection with the tournaments; 2) the applicant and parent/guardian grant and assign the applicant's his/her individual media/photo rights and all ancillary rights in perpetuity respecting participation in the competition, without exception to the sponsors, PGA of America, PGA Tournament Corporation, Inc., The Central Counties Chapter, and the PGA Section.


By my signature below, I hereby authorize tournament officials to seek medical attention for my child inclusive of but not limited to; hospitalization in the event my child suffers injuries or becomes ill while under the custody of the Central Counties.



Signature of Participant


Print Name of Participant



Signature of Parent or Guardian


Print Name of Parent or Guardian


Mail to:


George Adams : 520 Parkview Lane, Hanover, PA 17331