Register your child for the
H. Haney Golf Academy After School Program

Please take note of beginning dates, day of the week of program at your student's school and the time.
Student Name *
Student Name
Primary Emergency Contact *
Primary Emergency Contact
Phone *
Phone
Secondary Emergency Contact *
Secondary Emergency Contact
Phone *
Phone
Guardian Responsible for Pick-up *
Guardian Responsible for Pick-up
Image Consent *
H. Haney Golf Academy may at times take pictures during lessons or at times when trophies or awards are being presented. HHGA may display these pictures online or in various promotional and printed materials. We would like for you to be aware and comfortable with every action that involves your children. If you would or would NOT like your child’s picture used, please indicate below. Can HHGA use your child’s picture?
Participation *
I understand the cost of the program is $50 per month. A $5 discount will apply if the monthly fee is paid by the 7th of the month, making the payment $45. A $20 registration fee is due before the first class. Your child will be considered enrolled in our program upon payment of the registration fee and you will be responsible for the monthly payment until we are notified in writing of your child’s withdrawal. While my child is attending H. Haney Golf Academy’s After School Program, I acknowledge and assume all risks on their behalf and accept personal responsibility for any injury or damages that may occur. I release, waive, discharge and covenant not to sue H. Haney Golf Academy owners, management, agents, other participants and owners of the premises used to administer the program. I have read this waiver and release form and all disclosures and I am signing this form voluntarily. Distribution of this form through official district or school channels does not imply endorsement or support from Lexington - Richland 5 or any school therein.

If you are not comfortable purchasing after school registration online you can mail your registration form and check to H. Haney Golf Academy 6030E Saint Andrews Road Columbia, South Carolina 29212. Please note: your child is not registered until we have received the registration form and payment.