Please print and complete the application and mail your check Payable to: KAJGA

KAJGA at Concord Park        KAJGA at Beverly Park
10909NorthshoreDrive    or   5311BeverlyParkCircle                                                                           
Knoxville, TN 37922                Knoxville, TN  37918

O Family Membership - $190.00 / Can consist of any married couple or parents and any children 17 & under in immediate family

O Individual Membership - $125.00 / Junior, Senior or Adult

Payment Methods Accepted
Personal Check, Cash & Credit Card (Visa/MasterCard)
If paying by Credit Card there will a $5 service charge added to your fee

Credit Card # __________________________Expires _________ Zip Code________

CCV # _________ The 3 or 4 digit # on back of card

Please check the facility that you will be using the most: O Concord Park Par-3  or  O Beverly Park Par-3

Membership Application for Knox Area Junior Golf Association

Name and Birthdate of Each Junior Member

______________________________________  Birthdate ____/____/____
______________________________________  Birthdate ____/____/____
______________________________________  Birthdate ____/____/____
______________________________________  Birthdate ____/____/____

Parent/Member Name: ________________________________________________

Spouse Name:________________________________________________

Address: _____________________________________________________

City: __________________________ ST _____ Zip __________________

Phone : Home: ____________________    Work or Cell:____________________

E-Mail Address: ______________________________________________

I hereby understand and agree that Knox Area Junior Golf Association is not responsible for my child/children while on the premises of Concord Park or Beverly Park Par-3 Courses.

Parent Signature: ________________________________________

Date: ______________

For Office Use Only:
O Membership Cards             O 06 - 07 O Check # _________          O Cash      O Credit Card (add $5 fee)

Amount Paid: _________ Date: ___________