ADULT - Coaching Registration Form

Please enter below the details of the group you have been advised to join:
Day *
Date Started *

Day Month Year
Date
Time *

Hour Minutes

AM/PM Option
Coach [VIEW COACHES]
(If known - leave blank if unknown)
Other Information (e.g. additional groups, medical information etc)
Optional
Do you hold an account with us? *

Yes No
Name of the account holder
If you already have an account set up you will not need to create a new direct debit with us as all payments will automatically be collected from this account
British Tennis Membership Number Rating
If you do not have a BTM number, you will automatically be registered with the LTA

Please tick if you would like to opt out
EMERGENCY CONTACT
In case of emergency, we will need to contact a responsible adult, please give details:

(if applicable)
Name
Telephone Number
Mobile Preferred
Relationship

I understand that by completing and submitting this form I am giving consent to participate in the relevant session(s). Furthermore, I understand that should medical treatments be necessary, and I am unable to give consent myself, every reasonable effort will be made to obtain the consent of the emergency contact named above. However, in an emergency, I autherise the coaches/staff to consent on my behalf to any reqired medical treatment.

We may from time to time take photograps of your sessions and other players taking part in activites and may use them on our website on in other publications such as newpaper articles.
If you do not wish us to photograph you, please tick here
Signed *
Should be Empty:

ADULT Coaching Registration Form