In connection with my child's (for whom I am the authorized parent/legal guardian) participation in the BirdieBound Junior Golf Academy on June 23-25 (RD June 26) and/or July 21-23 (RD July 24) at Blackledge Country Club in Hebron, CT:

I, for myself and anyone related to me, release and hold harmless BirdieBound LLC, Blackledge Country Club, Nicole Damarjian, Eric DeStefano, and any and all associated teachers or sponsors from and against any liability, loss, damages, expense, claims, demands, causes of action, settlements or judgments of any kind or nature whatsoever, including attorneys’ fees, which I, my heirs, including but not limited to successors, assigns, executors or administrators may ever have against BirdieBound LLC, Blackledge Country Club, Nicole Damarjian, Eric DeStefano, and any and all associated teachers or sponsors on account of, or arising directly or indirectly in connection with my child's participation in the BirdieBound Junior Golf Academy and hereby waive any and all such claims, demands or causes of action.

I, on my own behalf and on behalf of my participating child (for whom I am the authorized parent/legal guardian), am fully aware of the risks and hazards connected with participation in the BirdieBound Junior Golf Academy, and I hereby elect to voluntarily allow my child to participate in the BirdieBound Junior Golf Academy. I, on my own behalf and on behalf of my participating child, VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING THE RISK OF CONTRACTING A COMMUNICABLE DISEASE OR ILLNESS OR DEATH, that may be sustained by my participating child, or any loss or damage to my participating child property, as a result of participating in the BirdieBound Junior Golf Academy, or while in, on or upon the premises where the BirdieBound Junior Golf Academy is being conducted or while in transit during and to and from the BirdieBound Junior Golf Academy.

I also authorize Blackledge Country Club and BirdieBound LLC to use my child's likeness in materials promoting the golf course and golf instruction.

By selecting the "I Accept" button, you are signing this Release and Waiver Form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Release and Waiver Form. By selecting "I Accept" you consent to be legally bound by this Release and Waiver Form 's terms and conditions and acknowledge that you have signed this document voluntarily and of your own free will.

Your registration is complete upon receipt of payment. I understand that I am reserving a space in the Junior Golf Academy. If I am unable to attend, my registration fee is only refundable if my space can be filled.