| First Name: |
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| Last Name: |
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| Address Street 1: |
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| Address Street 2: |
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| City: |
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| Zip Code: |
(5 digits) |
| State: |
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| Phone: |
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| Email: |
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Group Instruction |
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Private Instruction |
| How many days do you wish to receive instruction? |
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| How many people would be receiving instruction in a group? |
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| Please describe the golfing ability of each participant: |
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| Would you expect to remain together as a group for instruction? |
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| What are you looking to accomplish in the instruction? |
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| Length of time each day you wish to have instruction: |
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| Would you like to stay in the Cacapon Lodge on the park or in a nearby home?: |
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