AMP Junior Star Tennis Academy
Cut and paste into your word processor edit your information and email as an attachment to chad@amptennis.com OR - click here to download a printable version of this form Name __________________________ Age __ Date of Birth __________ Home Phone # ___________________ Mobile Phone # _______________ Work Phone # _______________Email Address _____________________ School Attending _________________________ Grade Level __________ Parents _____________________________________________________ Mailing Address _______________________________________________ City ___________ Zip Code ________ Site Location __________________
Please circle the class your child plans to attend: TNS 4 TOTS Twinkle Stars Tiny Stars Future Stars Superstars Tournament Stars Please circle the days your child plans to attend: Monday Tuesday Wednesday Thursday Friday Saturday
We, (I) the parent/guardian give permission for __________________ to participate in the AMP Tennis, LLC. tennis program(s). We, (I) hereby waive and release AMP Tennis LLC., and its staff or instructors from any liability, injury or illness incurred while participating in the programs. I have no knowledge of any physical impairment that would be affected by my child’s participation in the programs.
___________________________________________ Signature ___________________________________________ Printed Name _____________________ Date
OR Print and mail back to AMP Tennis LLC., PO Box 991 Concord, NC 28026-0991 |