2017 Registration Form for Medford Summer Tennis Clinic
(*Please visit the Schedule link for availability before sending in the registration form)
NAME OF CHILD:________________________________________________________________
DATE OF BIRTH:_________________________________________________________________
PARENTS/GUARDIANS NAMES: ___________________________________________________
Emergency Contact phone:__________________________________________________
SESSION: (please circle one) SESSION 1 SESSION 2
(July 10- July 21) (July 24- August 4)
AGE GROUP & CLASS START TIME: 5-6 (9:00-10:00) 7-9 (10:00-11:00) (please circle one)
TENNIS EXPERIENCE OF CHILD: never played played a little
(please circle one)
know basic strokes have played a match
ANY HEALTH/PHYSICAL ISSUES: (if none, please write none)__________________________
PLEASE READ AND SIGN BELOW: I release and hold harmless Medford Tennis Clinic and all personnel thereof, from all liability resulting from personal injury or loss to my child.
Check if you give permission for your child's photos to be used on our website and brochures.
Print and send this registration form with a check or money order.
MAKE PAYABLE TO: James Dickens
MAIL TO: Medford Summer Tennis Clinic, 70 Wright Street, Stoneham, MA 02180.
*You will receive an email or phone confirmation, once the registration is processed.
If you wouldn't mind, could you please tell us how you heard about the clinic: