HAFFEN PARK SPORTS ASSOCIATION

JUNIOR / ADULT TENNIS PROGRAM

REGISTRATION FORM : ADULT    JUNIOR (AGES 5-17) (Circle One)

NAME:_______________________________________________________________

ADDRESS:_____________________________________________________________

                    Street No. and or   Name                                                             Apt. #

City, State, Zip Code                                                                                                                  

TEL NO:_____________________          CELL NO .__________________

                  Area Code                                                                                  Area Code

SEX: CIRCLE ONE:                 MALE                        FEMALE

TENNIS EXPERIENCE: (CHECK ONE)

_______ BEGINNER         ______ INTERMEDIATE     _______ ADVANCED

MEDICAL CONDITIONS: ASTHMA?            YES                   NO

OTHER: PLEASE SPECIFY_____________________________________________

IN CASE OF EMERGENCY CONTACT:

NAME_______________________________                 TEL NO _________________

Waiver ( Junior ): I am the parent/guardian of the above named registrant. I hereby verify that my child is in

              good health and has permission to play. I waive and release any and all rights and claims against the

              members of Haffen Park Sports Assn.   Inc. for any injury or loss suffered while taking part in these

              lessons and instructions.

                                                                                 ________________________________________________

                                                                                 Signature:     Parent / Guardian

Waiver { Adult } I hereby verify that I am in good health and willing to participate in the tennis program.

               I waive and release any and all rights and claims against the members of Haffen Park Sports

               Assn Inc. for any injury suffered while taking part in these lessons and instructions.

                                                                               ________________________________________________

                                                                                 Signature

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