Buckhorn Springs Tennis Ciinic Registration Form

Buckhorn Springs Racquet Club

Fall 2023 Tennis Clinic Registration and Consent
*Please note that a 48-hour notice is required to register and/or remove your child.

If you have any questions, please contact our Club Director. Brandon Feldman at bfeldman@boomboomMgmt.com or 813-502-5160.
All sessions are 4 weeks, except the 1st and last of the season, which are 3 weeks each. Those shorter sessions will be prorated, accordingly.

Cost (4 weeks, 2x/week)

45 minute classes - $115

Hour classes - $150

1.5 hour classes - $225

2 hour classes $285
Clinic Sessions

*Invoices will be sent for each subsequent session unless notice is given 48-hours prior to the start of that session
Please select the session(s) you are starting:*

Session 1: August 14 - Sept 1Session 2: September 4 - 29Session 3: October 2- 27Session 4: Oct 30 - Dec 1Session 5: December 4 - 22
Please select which beginning/intermediate class you would like to attend Monday/Wed

K-2nd grade (Red) 3:45-4:30pm3rd-5th grade (Orange) 4:30-5:30pm6th-8th grade (Green/Yellow) 6:30-7:30pmHigh School (Yellow) 5:30-6:30pm
Please select which intermediate/advanced class you would like to attend Tuesday/Thursday

Orange Ball 6:00-7:00pmGreen Ball 5:30-6:30pm
Please select which Tournament Prep class you would like to attend

UTR less than 3.0; TuTh 6:30-8:00pmUTR above 3.0, MWF 4:30-6:30pm
Special Instructions (only 1 day/week, request private lesson, unsure on placement, etc.)*
Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number. Time-sensitive messages will be text to this number.
Primary Email*
*Important camp information and updates will be sent to the email address on file.
Parent/Guardian Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.. Time-sensitive messages will be text to this number.
Email
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Information
Child's Name*

First NameLast Name
Child's Gender*
Child's Date of Birth*

MonthDayYear
Child's Age*
Ball Level*
If you are registering more than one child, please fill out the fields below for each child.
Child's Name

First NameLast Name
Child's Gender
Child's Date of Birth

MonthDayYear
Child's Age
Ball Level
Child's Name

First NameLast Name
Child's Gender
Child's Date of Birth

MonthDayYear
Child's Age
Ball Level
Child's Name

First NameLast Name
Child's Gender
Child's Date of Birth

MonthDayYear
Child's Age
Ball Level
Any Known Allergies?*

YesNo
If yes, please list below:
Any Medications?*

YesNo
If yes, please list below:
Other Known Conditions*
*If none, please type N/A
Emergency Contact

The person(s) listed below are authorized to pick up my child from Buckhorn Springs Racquet Club
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship*
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Waivers and Releases
Release statement: The undersigned parent or legal guardian of the child/children listed above hereby consents and authorizes participation in Buckhorn Springs Racquet Club Youth Program. I understand that my child/children will engage in a number of sports and activities that require physical exertion and acknowledge that there is a risk of personal injury to my child/children. In consideration for Buckhorn Springs Racquet Club accepting the above names children into the Youth Program, I do hereby for myself, my spouse, my children, my heirs, personal representatives and assigns, forever discharge Buckhorn Springs Racquet Club, its agents, servants, associates, officers, directors, affiliates, sureties, successors, and either in law or equity, arising from or as a result of my child/children's participation in Buckhorn Springs Racquet Club Youth Program.
Name*

First NameLast Name
Signature*

Clear
Photo/Video Waiver: I knowingly give consent for the release of any photographic images that may be taken during my child’s participation in Buckhorn Springs Racquet Club Summer Camp for the use by Buckhorn Springs Racquet Club for use by Buckhorn Springs Racquet Club for its publications, promotional materials, website, social media, advertisement, press releases, and/or any other sanctioned materials. I hereby grant permission to the rights of my child’s image, likeness and without payment or any other consideration. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.
Name*

First NameLast Name
Signature*

Clear
Payment Information
Please select payment type*
*A team member will contact you for more details
Camp fees are $175/week or $65/day. Buckhorn Springs Racquet Club members, or Country Club members that opt in to the Racquet Club annual maintenance fee, enjoy a 10% discount on all tennis instruction. Invoices will be sent upon receipt of registration and liabiilty form completion.
Any additional notes or requests for the tennis camp?
Should be Empty:

Buckhorn Springs Racquet Club

Clinic Sessions

Parent/Guardian Information

Child Information

Emergency Contact

Waivers and Releases

Payment Information