FUTURE SCAPES YOUTH TENNIS Skills Workshop REGISTRATION FORM
Contact Gwendolyn Jackson, Camp Director with any questions: jackson.gwend@gmail.com or (980) 234-9880 .
Youth 1
Name
*
First Name
Last Name
Current Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
School currently attending
*
Rising or Current Grade
*
Gender Identity
*
Male
Female
Prefer not to answer
Other
Phone Number
Email Address
example@example.com
Does this participant have any physical, psychiatric, emotional or behavioral conditions of which the Tennis Camp Director should be aware of?
*
Restrictions on activities?
*
Drug allergies?
*
Food allergies/diet restrictions?
*
Tennis Level
*
Never/Plays some
Team player
Competitive player
Other
T Shirt Size
*
XS
S
M
L
XL
XXL
YOUTH 2
Name
First Name
Last Name
Current Age
Date of Birth
-
Month
-
Day
Year
Date
School currently attending
Rising or Current Grade
Gender Identity
Male
Female
Prefer not to answer
Other
Phone Number
Email Address
example@example.com
Does this participant have any physical, psychiatric, emotional or behavioral conditions of which the Tennis Camp Director should be aware of?
Restrictions on activities?
Drug allergies?
Food allergies/diet restrictions?
Tennis Level
Never/Plays some
Team player
Competitive player
Other
T Shirt Size
XS
S
M
L
XL
XXL
Parent/Guardian Details
Parent/Guardian Name 1
*
First Name
Last Name
Preferred Phone Number
*
Preferred phone number type
*
Cell Phone
Home Phone
Work Phone
Other
Secondary Phone Number
Secondary phone number type
Cell Phone
Home Phone
Work Phone
Other
Parent/Guardian Name 2
*
First Name
Last Name
Preferred Phone Number
*
Preferred phone number type
*
Cell Phone
Home Phone
Work Phone
Other
Secondary Phone Number
Secondary phone number type
Cell Phone
Home Phone
Work Phone
Other
Emergency Contact if parent(s)/guardian(s) cannot be reached:
*
First Name
Last Name
Relation to youth/s
*
Preferred phone number
*
Please enter a valid phone number.
Other Phone Number
Please enter a valid phone number.
Media Consent
Occasionally, photos are taken during Youth Group, Youth Forum (Sunday School), or other youth activities and trips. Please choose on the line that best describes your family's wishes:
*
Yes, I give permission for Youth 1(and Youth 2, if applicable) photo to appear in publications, promotional materials, displays,websites, social media outlets including Instagram, or media coverage including newspapers or televisionorganized of authorized by Future Scapes Inc.
No, I do not give permission.
*
To the best of my knowledge, all registration information is correct. I give permission for Youth 1 and Youth 2 (if applicable) to participate in the camp. Its staff, volunteers, and the vendors will not be held responsible for any accidents, personal injury, or illness arising from participation therein. I agree that the camp staff are not responsible for lost or damaged personal property.
Authorized parent/guardian signature.
*
Date Completed
-
Month
-
Day
Year
Date
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