Registration Enrolment Form

Name

First NameLast Name

Email

example@example.com

Contact number:

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Where did you hear about us?

InternetFriendSchool newsletterother, facebook

Ambulance Cover

YesNo

Student Name:

First NameLast Name

Date of Birth/ Age:*

Date

Hot Shots/ Group Lesson Class Day

MondayWednesdayThursday

Medical Conditions

CHILD 2:

First NameLast Name

Date of Birth/ Age:

Date

Medical Conditions:

Hot Shots/Group lesson class day

MondayWednesdayThursday

I Authorise the coach on duty to take any reasonable medical action necessary on my behalf, should the need arise, including calling for an ambulance at my own expense if its deemed neccessary.

Signature

GD TENNIS COACHING ENROLMENT FORM

STUDENT INFORMATION