Spring 2010 Junior Tennis Academy Application Form
Willow Fork Country Club
21055 Westheimer Parkway, Katy TX 77450
willowforktennisshop.com                                                                                          281-579-3508

Please print legibly!                    Return form with check to Willow Fork Tennis Shop.

Junior's name:_____________________________________Age_______Birthdate (mm/dd/yyyy)________________

Responsible Adult's name_________________________________________________________________________

Please circle one:            Member               Non-Member

Address:_________________________________________________________________________________

City:________________________State:_____Zip_____________Home # ____________________________

Cell # __________________________email___________________________________________________

 

Academy Division Entered: (Please circle One):

Wimbledon           Masters           Challenger           Australian Open           Canadian Open           Pee Wee Tennis

 

Amount Paid__________________Date Paid__________________Check No._____________________

 

Liability and Medical Release: I hereby release Willow Fork Country Club Management, its employees, tennis professionals, and sponsors of all responsibility in the event of accident or injury to my son/daughter.  I also consent to emergency medical and/or hospital service that may be sought for the student by the WFCC professional staff.

                         

Responsible Adult's Signature______________________________________Date_______________

 

11/25/09