Academy Select, Academy Futures & Teen Tennis Application

Player's First & Last Name(*)

Invalid Input

Player's DOB(*)

Invalid Input

Parent/Guardian's First & Last Name(*)

Invalid Input

Street Address(*)

Invalid Input

City/Town(*)

Invalid Input

Zip(*)

Invalid Input

Best Reached Phone(*)

Invalid Input

Email(*)

Invalid Input

Confirm Email(*)

Invalid Input

Current USTA/UTR Rating

Invalid Input

High School Position(*)

Invalid Input

Interest in playing Tournaments(*)

YesNo

Invalid Input

Aspiring Level(*)

Invalid Input

Please indicate desired program(*)

Invalid Input

Program Availability(*)

Invalid Input

Parent/ Player Comments/Questions: (*)

Invalid Input

By clicking this box I realize that tennis programs are of a physical nature and the Kingsbury Club, its shareholders, directors, officers, employees, representatives and agents cannot be held responsible for any loss, claim, injury, damage, or liability sustained or incurred during participation in our programs on the premises of Kingsbury Club Medfield, 2 Ice House Road, Medfield, MA. I acknowledge and permit the Kingsbury Club the right to photograph program participant for publicity purposes, in print or electronic media.

( I UNDERSTAND THE REGISTRATION, CANCELLATION & MAKE-UP POLICY ) REGISTRATION, CANCELLATION & MAKE-UP POLICY: No refunds or credits once the program has started for any reason besides injury (accompanied by a doctor's note). Payment is due before the first class, if you have not paid, you're spot is not secure. It is your responsibility to contact Jillian 774.469.3052 to provide payment information if you are a non-member or do not wish to be house-charged. Credits will be given for classes canceled by the Kingsbury Club. Coaches reserve the right to move your child to the proper class based on skill. The Kingsbury Club reserves the right to cancel programs due to insufficient enrollment. We do not offer Make-Ups for the 12 & Under Youth Tennis Programs.

(*)

I have read and understood the above disclaimers

Invalid Input

Teen Tennis, Futures Academy & Academy Select Registration Form