All information on the Application, Parental Authorization and Medical Physicians Approval forms MUST be completed in order to guarantee a place in the camp. 

fill out and send it to us at;

CEC Business Services
Purdue University
Stewart Center, Room 110
128 Memorial Mall
West Lafayette, IN. 47907-2034
Fax (765) 494-0567

Coaches Golf Physician Approval

I have examined ___________________________________and found him/her to be healthy to compete in golf and general recreational activities of his/her choosing during the 2008 Coaches Golf School.

Medical Conditions:          

Current Medications:  
Allergies:  
Date of last Tetanus Shot:  
Physician's Signature:  
Phone:  


Emergency Contact

1st Contact - Name:  
Relationship to Participant:  
Day Phone:  
Night Phone:  
2nd Contact - Name:  
Relationship to Participant:  
Day Phone:  
Night Phone: