Quickstart

Program Sign-up Form Summer 2013

Student name: ______________________________________________________________

Students e-mail (optional): ___________________________________________________ Please PRINT Parent/Guardian Name: ___________________________________________ Parent/Guardians e-mail Address: _____________________________________________ Address: ___________________________________________________________________

City: ___________________________________________ State: _______ Zip: _______ Phone Number: ___________________________ Cell #: __________________________

Amt. enclosed = $__________ Method of Payment: Cash Check Credit Card

Pro Approval: ____________ Circle Program: Quickstart Junior Introduction to Tennis Quickstart Quickstart Academy Days / Time: ___________________________ Circle Session: Session 1: June 10 July 6 Session 2: July 8 July 27 Session 3: July 29 August 17

Student will attend classes on: Monday Tuesday Wednesday Thursday Friday Saturday

Parent or Guardian Signature: ______________________________________________ Date: ________

BY SIGNING ABOVE, IT IS ACKNOWLEDGED THAT ALL PARTICIPANTS AND PARENTS MUST BE ADVISED THAT NEITHER THE RACQUET CLUB OF COLUMBUS, ITS EMPLOYEES, OFFICERS, OR ANY REPRESENTATIVE THEREOF, ARE RESPONSIBLE IN ANY MANNER FOR ANY INJURY THAT RELATES TO OR MAY RESULT FROM ACTIVITY IN THIS PROGRAM OR ANY RELATED PROGRAM IN ANY WAY. ANY DAMAGE THAT MAY OCCUR AS A RESULT OF THE ACTION OF ANY PROGRAM PARTICIPANT, OR AFFILIATE PERSON, WILL BE THE RESPONSIBILITY OF THAT PERSON (OR PARENT/GUARDIAN). THE RACQUET CLUB OF COLUMBUS AND ANY AND ALL OF ITS AFFILIATES ASSUME NO RESPONSIBILITY, IN ANY WAY, FOR THE ACTIONS THAT MAY INVOLVE THE ABOVE, OR ANYTHING THAT MAY BE DETRIMENTAL TO THE ABOVE, EITHER FINANCIAL OR OTHERWISE.

Children aged 13 and under must be under the direct supervision of a parent or guardian at all times while at the Racquet Club. To be under direct supervision, children must be within eye-sight of the parent or guardian, and the parent or guardian must know at all times where the children are and what they are doing. Children of any age cannot be dropped off and left at the Racquet Club for extended periods of time (more than a few minutes). When children are not under the direct supervision of a tennis professional or program director, parents or guardians must be on the premises and in direct supervision of their children.

***** CHILDREN MUST BE DIRECTLY SUPERVISED AT ALL TIMES WHILE AT THE RACQUET CLUB *****