SPRING JUNIOR EXCELLENCE REGISTRATION FORM – MONDAY for intermediate and advanced level players SPRING JUNIOR EXCELLENCE Welcome to the Green Tree Spring Junior Excellence on line entry form. To enroll you child in our camps, please provide the information on the next pages. You must secure your camp reservation with a credit card. Step 1 of 5 - PARENT/GUARDIAN INFORMATION 20% Name* First Last Email* Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Day Phone*Night Phone*Cell PhoneClick this box if you are a member of Green Tree Tennis Yes How many of your children will be attending this program?*123456How many of your children will be attending this program?*123456Child 1Child 1* First Name Last Name Child 1 Birth Date*Child 1 School*Child 1 MedicalPlease check if child has medical problems and/or taking medication Yes Child 2Child 2* First Name Last Name Child 2 Birth Date*Child 2 School*Child 2 MedicalPlease check if child has medical problems and/or taking medication Yes Child 3Child 3* First Name Last Name Child 3 Birth Date*Child 3 School*Child 3 MedicalPlease check if child has medical problems and/or taking medication Yes Child 4Child 4* First Name Last Name Child 4 Birth Date*Child 4 School*Child 4 MedicalPlease check if child has medical problems and/or taking medication Yes Child 5Child 5* First Name Last Name Child 5 Birth Date*Child 5 School*Child 5 MedicalPlease check if child has medical problems and/or taking medication Yes Child 6Child 6* First Name Last Name Child 6 Birth Date*Child 6 School*Child 6 MedicalPlease check if child has medical problems and/or taking medication Yes Sessions and PricingJunior Excellence will run for four weeks with players meeting on Monday afternoons 5:30 p.m. – 7:00 p.m. This program is for intermediate and advanced level juniors who are playing or wanting to play on their school teams and/or competing in USTA tournaments..Please select the number of sessions (member pricing):*1 Session2 Sessions3 SessionsThe prices for Spring Junior ExcellencePlease select the number of sessions (non-member pricing):*1 Session2 Sessions3 SessionsThe prices for Spring Junior Excellence.Price for 1 session per child (member pricing)Price for 2 sessions per child (member pricing)Price for 3 sessions per child (member pricing)This price includes the 10% discount when signing up for 3 session plus 5% full payment discount. (savings of $41.32)Price for 1 session per child (non-member pricing)Price for 2 sessions per child (non-member pricing)Price for 3 sessions per child (non-member pricing)This price includes the 10% discount when signing up for 3 session plus 5% full payment discount. (savings of $45.67)Total for One ChildTotal for All Children Price: $0.00 Select Which Sessions*This registration is for Spring Junior Excellence. Session 1: Feb. 24, March 2, 6, 23 (no meeting March 9 Spring Break) Session 2: March 30, April 6,13, 20 Session 3: April 27, May 4,11,18 Below is your total registration fee.Sibling Discount Price: $0.00 Processing Fee Price: $10.00 A non-refundable processing fee of $10/child is added to your registration.Total for All Children $0.00 Waiver InformationRelease of Liability*By signing this Medical Release and Liability Form, I expressly warrant and assume all risks to the child named above participating in the activities, whether such risks are known or unknown to me at this time. I further release Green Tree Tennis Club, its owners, employees, staff, volunteers and agents from any claim that my child may have or that I may have against them as a result of injury or illness incurred during the course of participation in these activities. I further agree to indemnify and hold harmless Green Tree Tennis Club, its owners, employees, staff, volunteers and agents from any and all claims arising from my participation in its activities and programs, or as a result of injury or illness of my child during such activities. I accept First Aid and Emergency Medical Treatment*I recognize that there may be occasions where the child named above may be in need of first aid or emergency medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of Green Tree Tennis Club to seek and secure any needed medical attention or treatment for the child named above including hospitalization, if in the agent’s opinion such need arises. In doing so, I agree to pay all fees and costs arising from this action to obtain medical treatment. I accept CREDIT CARD CHARGES*My credit card will be charged the above amount. I accept CREDIT CARD AUTHORIZATION*FOR VISA, MC, AMEX or Discover credit or debit cards: I authorize a representative of Green Tree Tennis Club to charge any unpaid tennis/sports camp, snack bar and/or early or late drop off balances for the child named above to my MC, VISA, AMEX or Discover credit or debit card. I Authorize Please complete the information below and press the button only once. Pressing the button multiple times will charge your credit card multiple times.Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name
