TFL WAIVER/RELEASE FORM

Tennis for Life is for breast cancer survivors and thrivers. Are you a breast cancer survivor or thriver?*

YesNo

Name*

First NameLast Name

Your Email*

example@example.com

Phone Number*

Area CodePhone Number

What city/town do you live in?

What county do you live in?

Birthday Month*

Primary Emergency Contact - Provide first/last name, relationship and phone number*

Secondary Emergency Contact - Provide first/last name, relationship and phone number

How did you hear about us?*

Which location do you prefer as your primary location for your tennis clinics?*

CaryRaleigh

I approve that my contact information may be used in Tennis for Life communications*

YesNo

Tennis for Life Waiver/Release

With my signature, I hereby acknowledge that tennis can be a strenuous activity with inherent risks. I have consulted with my physician regarding my physical capability to participate in this program and am following my physician’s advice. I hereby waive all claims against Tennis For Life, Western Wake Tennis Association, Raleigh Tennis Association, North Carolina Tennis Association, WakeMed Health & Hospitals, all of the facilities that Tennis for Life uses, along with all other sponsors, volunteers, or personnel functioning with this program for myself, heirs, executors, and administrators for any injury, accidents or physical conditions I might suffer in this program. I further waive all claims against Tennis For Life, Western Wake Tennis Association, Raleigh Tennis Association, North Carolina Tennis Association, WakeMed Health & Hospitals, all of the facilities that Tennis for Life uses, along with all other sponsors, volunteers, or personnel functioning with this program for myself, heirs, executors, and administrators for any exposure to any communicable diseases. I grant full permission for the organizers to use my name, likeness, or voice and photographs, videotapes or quotations from me in accounts and promotions of this program in any medium.

By signing below and submiting this form, I understand and agree to the waiver/release form.

Signature*

Tennis for Life Registration & Waiver Form