JUNIOR GROUP LESSON SERIES
sponsored by Perth Tay Tennis Club
Name of Parent/Guardian
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Back
Next
Name of Child #1
*
First Name
Last Name
Age as of July 1, 2025
*
Health Card Number
*
Please list any allergies or other health situations the staff should be aware of
*
Emergency Contact Name and Telephone Number (if different from first page)
Register child for (check sessions):
*
Junior Group Lesson Series 1 from 4:00-5:30 (June 7, 14, 21, 28)
Junior Group Lesson Series 2 from 4:00-5:30 (July 19, 26, August 9, 16)
Junior Private Lesson Series 3 from 12 to 1:30 (July 5, 12)
Name of Child #2
First Name
Last Name
Age as of July 1, 2025
Health Card Number
Please list any allergies or other health situations the staff should be aware of
Emergency Contact Name and Telephone Number (if different from first page)
Register child for (check sessions):
Junior Group Lesson Series 1 from 4:00-5:30 (June 7, 14, 21, 28)
Junior Group Lesson Series 2 from 4:00-5:30 (July 19, 26, August 9, 16)
Junior Private Lesson Series 3 from 12 to 1:30 (July 5, 12)
If more than two children are attending please fill out another application.
Back
Next
PAYMENT The cost for one series of GROUP instruction for one child is $130 (1 child for two sessions or 2 children for one session is $260). The cost for Series 3 PRIVATE instruction for one child is $90. This application form will be accepted only upon receipt of payment. Payment can be made by e-transfer to payment@perthtaytennis.ca, or cheque payable to the Perth Tay Tennis Club, sent to Tom Baumgartner, 396 Gold Creek Rd., Lanark, ON K0G 1K0. In the event of cancellations by the club for weather or other reasons, you will be reimbursed an amount directly proportionate to the number of cancellations by a cheque mailed to your address. Participants are eligible for a full refund, less a $10 administrative fee, for cancellations at least a week before the beginning of the series. AGREEMENT By submitting this application form, you acknowledge that: 1. The Perth Tay Tennis Club is not responsible for any loss or damage to personal property. 2. The series program is planned and implemented entirely by the staff of an independent organization who are qualified, certified tennis instructors which Perth Tay Tennis Club have contracted for this purpose. 3. Your child will follow all reasonable instructions from the staff of the clinic while participating in the program. 4. The clinic instructor reserves the right to cancel a child's participation in a session if their behavior is deemed unmanageable or dangerous to themself or others. 5. You release the tennis clinic staff, the Perth Tay Tennis Club and its Board of Directors, and the Town of Perth of and from all manner of actions, claim and demands of whatever nature which result from any loss, injury or expense sustained, arising out of or in any way connected with your child's participation in the tennis clinic. 6. In the event your child is injured, ill or in need of medical attention and you are unable to be contacted, you authorize the staff to seek medical attention on your behalf.
I accept the above terms
*
Check box to accept
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: