Tennis Wavier & Info
Located at Quail Valley Swim & Racquet Club. 1336 Country Squire Drive Columbia SC 29212
Student Name
*
First Name
Last Name
Address
*
Street Address
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City
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*
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Date of Birth
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Guardian Information
Emergency Contact (Parent/Guardian)
*
First Name
Last Name
Emergency Contact Email
*
example@example.com
Emergency Contact Phone Number
*
-
Area Code
Phone Number
Relation to student
*
Students Medical Conditions & Allergies
*
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Tennis & Fitness Programs
PARTICIPATION TERMS: As a participant in the Ds Tennis & Fitness Programs at Quail Valley, my child/myself agrees to abide by the rules and regulations established by the Club regarding the use of the facilities, rules of play, and etiquette. My minor child and I will hold Ds Tennis & Fitness and QVSR harmless from any and all liability while myself or my child is participating in the Tennis & Fitness Programs. PARENTAL CONSENT: I, the undersigned parent or guardian of the participant, do hereby grant authority to the staff of Ds Tennis & Fitness to render a judgement concerning medical assistance or hospital care in the event of an accident or illness during my absence. I do hereby authorize Ds Tennis & Fitness and its assigns to utilize any and all videos, pictures, or other likenesses of participant or anyone assigned guardianship as they deem appropriate in its promotional materials.
Signature
*
By signing this you are agreeing to the participation terms.
Date
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