Challenger Circuit Junior Tour Signup - Courtside Racquet Club

Challenger Circuit Junior Tour Signup – Fall 2017

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Participant First Name *

Participant Last Name *

Date of Birth *

Age *

Parent / Guardian Name *

Cell Phone *

Home Phone

Email *

Address *

City *

Zip / Post Code *

Emergency Contact Name *

Emergency Contact Phone *

VIP Number (Payment)

By checking this box, you agree to the following Release Statement:

I, the parent/guardian of the Participant, a minor, hereby agree that the Participant and I will abide by the rules of Courtside Racquet Club, LLC and we hereby release, discharge, and/or otherwise indemnify Courtside Racquet Club, LLC, its owners, officers, employees and instructors against any claim by or on behalf of the Participant or any third party arising out of Participant's involvement in any activities at Courtside Racquet Club. I certify that the Participant is healthy, in sound physical condition and otherwise competent to participate in activities at Courtside Racquet Club. In my absence, I hereby authorize and consent for the Participant to be transported for emergency medical care, if necessary, and for such emergency medical treatment as may be determined to be in Participant's best interest by the appropriate medical personnel.

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Challenger Circuit Junior Tour Signup – Fall 2017

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