GTA Registration Form (Copy and print or scan and email to: reaganwillman@gmail.com)


Child's Name:______________________________________________


Child’s Date of birth:________________________________________

Known Allergies:___________________________________________

Parent’s Name:_____________________________________________

Parent’s Phone: ____________________________________________

Parent’s Email:______________________________________________

Emergency Contact:_________________________________________

Emergency Contact Phone:____________________________________

I am registering for (check all that apply, and include dates as dates change yearly)

___Fall After School Tennis Classes

___Spring After School Tennis Classes

___Summer Fun Camp (specify date)

___Golf, Tennis and Swim Camp (specify date)

___Tennis Camp (specify date)

___Other (please specify)

I acknowledge that camps and classes require outdoor physical exercise and activities.   I am aware that my child is in good health, and I do not hold Georgetown Country Club, or Georgetown Tennis Academy personally liable in case of illness or injury. 

 

___________________________________________             _____________________________________

Parent’s Signature                                                                           Today’s Date.