SCTA Detailed Registration Form

SCTA-ELDO SCHOOL YEAR 21-22 AFTER SCHOOL REGISTRATION

Sept 1, 2021 thru May 31, 2022
Only (1)One Player Per Form

All sales are final. No refunds.

Summer credits CANNOT rollover to Fall. Monthly sessions CANNOT rollover to the next month.
Player Information
Player Name *

First Name Last Name
Birth Date *

Month Day Year
Grade *
Gender *

Male Female
Birth Date

Month Day Year
Grade
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian Information
Name *

First Name Last Name
Cell Number *

Area Code Phone Number
E-mail *
example@example.com
Emergency Information
Emergency Contact's Name *

First Name Last Name
Relationship *
Phone Number *

Area Code Phone Number
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe. *
Is the athlete prescribed an inhaler? If yes, please explain any instructions. *
Parent/Guardian Responsibilities

I/We will inform Southern California Tennis Academy (SCTA) about any serious medical condition or disability of the learner, either existing or arising.

I/We will inform SCTA immediately of changes of address or telephone number of parents/guardians.

I/We agree that we and our child/children will follow all SCTA policies and regulations.

I/We agree to settle all financial obligations as they come due.
Program Option *

SCTA - High Performance SCTA - FUNdamentals SCTA - Costa Mesa

My Products *

SCTA-ELDO SCHOOL YEAR 21-22 AFTER SCHOOL REGISTRATION