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PACIFIC PINES GOLF & SOCIAL CLUB

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Minor Waiver and Release of Liability

Pacific Pines Golf and Social Club - Minor Waiver and Release of Liability Agreement 11.10

Minor Waiver and Release of Liability Agreement

Guardian Full Name*

Child Full Name*

Child Date of Birth*

Month

Day

Year

Relationship to Child*

Father

Mother

Other

Emergency Contact Phone*

Emergency Contact Email*

I confirm that I have read, understood, and agree to the terms of the Minor Waiver and Release of Liability on behalf of my child.

Confirm with your initials*

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(503)536-3343

info@pacificpinesgolf.com

3300 SW Hocken Ave, Suite 108

Beaverton, OR, USA

Contact Us

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Phone*

Email*

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