THE JUNIOR TOUR - sponsored by NIKE GOLF - Central Illinois Junior Golf Tournament Series

2010 "PICK TEN" REGISTRATION

Player First Name:        Player Last Name:

Gender:             Date of Birth:         Shirt Size:

Daytime Phone:           Parent/Guardian Work or Mobile Phone:

Player Email:          Parent/Guardian Email:

Mother/Female Guardian First Name:    Mother/Female Guardian Last Name:

Father/Male Guardian First Name:        Father/Male Guardian Last Name:

Health Insurance Provider:

Home Golf Course:        Average 18 Hole Score:

School Attending in Fall 2010:

Grade in School for Fall 2010:             Expected Year of High School Graduation:

Hometown/Local Newspaper:

How did you hear about THE JUNIOR TOUR?:

When you are finished, please click button only once. You will be taken to our secure website to enter your credit card information.