ICM TENNIS PRIVATE LESSON REGISTRATION FORM
Please complete all required details. One form per person.
Location & Lesson Type
All fields below are required unless marked as optional.
Location:
*
Oshawa
Lesson Type:
*
Private (class with 1 player) -
(AVAILABLE)
Semi Private (class with 2 players) -
(AVAILABLE)
Back
Next
Program Fees
All fields below are required unless marked as optional.
PROGRAM FEES PRIVATE LESSONS:
*
$1,000 + Tax - (10 Sessions)
PROGRAM FEES FOR SEMI PRIVATE LESSONS:
*
$1100+ Tax - (10 Sessions)
TOTAL FEES FOR PRIVATE LESSONS (INCLUDING 13% HST/GST)
TOTAL FEES FOR SEMI PRIVATE LESSONS (INCLUDING 13% HST/GST)
TOTAL FEES (INCLUDING 13% HST/GST)
Back
Next
Lessons Time
All fields below are required unless marked as optional.
Please select a time:
*
Tuesdays 07:00 - 08:00 AM
Tuesdays 08:00 - 09:00 AM
Thursdays 09:00 - 10:00 AM
Thursdays 10:00 - 11:00 AM
Thursdays 07:00 - 08:00 PM -
(FULLY BOOKED)
Fridays 05:00 - 06:00 PM
Fridays 06:00 - 07:00 PM
Fridays 07:00 - 08:00 PM
Fridays 08:00 - 09:00 PM
Main Email Address
Please enter your active email address for effective communication
Main Email Address:
*
example@example.com
Back
Next
General Information - Player 1
All fields below are required unless marked as optional.
Player 1 Age Group
*
Kids/Juniors (Age 3 to 17)
Adult (Age 18 and higher)
Child Name
*
First Name
Last Name
Parent/Guardian 1 Full Name
*
First Name
Last Name
Parent/Guardian 2 Full Name
First Name
Last Name
Child Gender
*
Female
Male
Another Gender
None (i.e. blank)
Child Date of Birth
*
-
Day
-
Month
Year
Parent/Guardian Mobile Number
*
Format: 000 0000000.
Parent/Guardian Email
*
example@example.com
Player 1 Full Name
*
First Name
Last Name
Player 1 Gender
*
Female
Male
Another Gender
None (i.e. blank)
Player 1 Date of Birth
*
-
Day
-
Month
Year
Player 1 Mobile Number
*
Format: 000 0000000.
Player 1 Email
*
example@example.com
Player 1 Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(Player 1) Do you allow us to take photos and videos during the program and share it to THE BILLIONAIRE TENNIS social media?
*
Yes
No
Current Medications, Medical Conditions, Allergies
Player 1
Please type "No" or "None" if you don't have any medical conditions or allergies or using any medications.
*
Consent (Player 1):
*
I hereby release The Billionaire Tennis and all of its employees from all claims for damages arising from any accidents or injuries which are caused by arise from participation of the applicants named above, during any program or in any facility or at any location where the program is being held
Back
Next
General Information - Player 2
All fields below are required unless marked as optional.
Player 2 Age Group
*
Kids/Juniors (Age 3 to 17)
Adult (Age 18 and higher)
Child Name
*
First Name
Last Name
Parent/Guardian 1 Full Name
*
First Name
Last Name
Parent/Guardian 2 Full Name
First Name
Last Name
Child Gender
*
Female
Male
Another Gender
None (i.e. blank)
Child Date of Birth
*
-
Day
-
Month
Year
Parent/Guardian Mobile Number
*
Format: 000 0000000.
Parent/Guardian Email
*
example@example.com
Player 2 Full Name
*
First Name
Last Name
Player 2 Gender
*
Female
Male
Another Gender
None (i.e. blank)
Player 2 Date of Birth
*
-
Day
-
Month
Year
Player 2 Mobile Number
*
Format: 000 0000000.
Player 2 Email
*
example@example.com
Player 2 Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(Player 2) Do you allow us to take photos and videos during the program and share it to THE BILLIONAIRE TENNIS social media?
*
Yes
No
Would you like to be added to our email list?
*
Yes
No
Current Medications, Medical Conditions, Allergies
Player 2
Please type "No" or "None" if you don't have any medical conditions or allergies or using any medications.
*
Consent (Player 2):
*
I hereby release The Billionaire Tennis and all of its employees from all claims for damages arising from any accidents or injuries which are caused by arise from participation of the applicants named above, during any program or in any facility or at any location where the program is being held
Back
Next
TOTAL FEES INCLUDING 13% HST/GST
prev
next
( X )
CAD
Description
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Print Form
Submit
Should be Empty: