CCS Golf Performance Program Registration

Registration

Please fill out the following information so that we can get you started with the program!

Name

First Name

Last Name

Phone

(###)

###

####

What is your current Golf Index (Handicap)

What areas of your body would you like to see improved as it relates to your golf swing?

How long have you been playing golf?

If you have a history of medical conditions/diagnoses, surgeries or major injuries, please list them here.

Do you experience pain during and/or after golf?

Are you currently receiving golf instruction, golf fitness training, or physical therapy at CCS? If Yes, please indicate which of these services you are receiving.

Registration

Club PT