Wednesday, June 19th, 2013
Complete the form below to register for an instructional tennis clinic.
First Name (required):     Last Name (required):
Gender: ---MaleFemale Ability: ---Never PlayedBeginnerAdv BeginnerIntermediateAdv IntermediateAdvanced
City: State: ZIP:
Email (required): Home Phone:
Work Phone: Cell Phone:
Program I am interested in: ---FuturesPremier IPremier IIELITESUPREME
Day: ---MondayTuesdayWednesdayThursdayFridaySaturdaySunday Start Time:
Additional or Second Choice Program: None Second Choice Additional
Choose a Program: ---FuturesPremier IPremier IIELITESUPREME
High Performance Membership Status: ---Current MemberTime to RenewNew Member
It is expressly agreed that all use of the Tennis and/or Fitness Facilities and/or Pool at Nassau Racquet & Tennis Club (the Club) shall be undertaken by a Junior Participant (Jr.) at his or her sole risk, and the Club shall not be liable for any injuries or damage to any Jr. or guest, or the property of any Jr., or be subject to any claim, demand, injury or damages whatsoever, including, without any limitation, those damages resulting from acts of active or passive negligence on the part of the Club, its successors or assigns, as well as its officers and agents, for all such claims, demands, injuries, damages, actions or causes of actions. It is specifically agreed that the Club shall not be responsible or liable to Jr’s for articles or property lost or stolen in the Club. It is also agreed that any damages to the Club facilities or property or to the property of any Jr. by another Jr. is the sole responsibility of the offending Jr’s parent or guardian.
Additionally, payment is required in advance, and by submitting this form, I explicitly agree to remit full payment for class(es) or program(s) selected herein, whether I attend or not.
Above named Parent or Guardian agrees to the Liability Waiver and Payment Commitment with this electronic signature.
EMERGENCY CONTACT: EMERGENCY PHONE:
Serving New Jersey including Princeton, Hillsborough, Bridgewater, Montgomery (Belle Mead & Skillman), Hopewell and the Surrounding Areas.
Nassau Tennis Club, 1800 Route 206, Skillman, NJ 08558 | 908-359-8730
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