|
Participant’s Name:_________________________
___boy ___girl (check one) Child’s age:______ Date of birth:_________
Street Address_______________________________________
City, State, Zip:_______________________________________
Phone:_________________(home)_______________________(office/cell)
Level (check one) ___Beginner ___Low Intermediate ____Intermediate ___Advanced
Programe Name:___________________________
Session number:___Time:_____________________(1st Choice)
Session number:___Time:_____________________(2nd Choice)
Session number:___Time:_____________________(3rd Choice)
Signature:_________________________________
Program spots will be lost if registration payment is not received my June 15, 2009
Parent/legal guardian signature required under 18 years of age, allowing participation and waiving any claims that may result in injury as a result of tennis activity. Every effort will be made to accommodate all requested program schedules, however, all classes must have sufficient enrollment to run. Sorry, no make-up classes will be offered.
IMPORTANT! To participate in the above programs you must register and pay by Monday June 15, 2009.
To register for any of the programs listed please fill out the information above and mail it with your check or credit card information for payment in full to:
The Racquets Club of Warren
149 Mt Bethel Road
Warren NJ 07059
Please make checks payable to: The Racquets Club of Warren
_________________________PAYMENT INFORMATION_________________________
PLEASE PRINT
Payment Method: ___ Check Enclosed(make check payable to The Racquets Club or Warren)
___Visa ___MasterCard
Amount of payment (payment in full is required for registration): $_________
Name as it appears on credit card:____________________________
Credit card billing address: _________________________________
__________________________________
Card Number: ______________________________________
Exp date:____/____ CVV/CVC*_____
*This number is the last three digits printed in the signature area on the back of your card.
Card holder signature: ____________________________________
|
