Camp Olympia Junior Golf Registration Camp Olympia Junior Golf Academy 723 Olympia Drive Trinity, TX 75862 phone (800) 735-6190 fax (936) 594-8143 Please fill out this form and submit it to us, or alternately, print it and either fax or mail it to us: Camper's Name: Male:  Female: Parent's Name: Date of Birth: Street Address: City: State: Zip Code: Telephone #: Email Address: Year Camper: Cabin Mate Request: Golfing Ability: Beginner   Intermediate  Advanced  Tournament Recommended By: Term Preference: Golf 1: June 8 - June 21       $2905.00 (14 days) Golf 2: June 22 - July 12      $3990.00 (21 days) Golf 3: July 13 - August 2     $3990.00 (21 days) Golf 4: Aug. 3 - August 16    $2905.00 (14 days) Payment Type: Visa MasterCard Discover Credit Card Number: Expiration Date (mm/yy): -Select- 01 02 03 04 05 06 07 08 09 10 11 12 / -Select-07080910111213    A NON-REFUNDABLE Deposit of  $250 per child is required to secure your golfer a space. Balance is to be paid by May 15, 2009. A 5% discount for each additional camper from the same family.