Join our Junior Classes Parent/ Guardian Name * The individual named below is completing this form and is 18 years of age or older, acting on behalf of a participant who is under 18 years old. First Name Last Name Email * Phone * (###) ### #### Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Are you the guardian or parents? * Mother Father Guardian Participant Name * Please enter the full name of the child you are registering First Name Last Name Date of Birth of the participant * Date of Birth of the Child MM DD YYYY School Name Does the participant have any medical conditions or injuries we should be aware of? * * yes no if Yes- please specify including medication taken and any allergies: In my absence,I give permission for the following person(s) to pick up my child on my behalf * * Authorized person full name or any other useful information How would you like to be contacted for updates on events and coaching sessions? Email Whatsapp Group Both I do NOT wish to be contacted Emergency Contact * primary contact First Name Last Name Emergency Contact Phone * primary contact (###) ### #### Emergency Contact Email * primary contact Emergency Contact Home Address * primary contact Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact secondary contact First Name Last Name Emergency Contact Phone secondary contact (###) ### #### Emergency Contact Email secondary contact Do you give permission to be photographed or recorded during activities, and for the images or videos to be used for things like our website, social media, or newsletters * Yes No I am aware of the presence of CCTV surveillance on BLTC premises. A copy of the CCTV policy is available for review upon request. * I acknowledge By ticking this box, I acknowledge that this serves as my consent in place of a signature. * * signed By checking this box, I acknowledge that I have reviewed and accepted the terms and conditions. * link below on our website for full detail I have read, understood, and agree to the Terms and Conditions Bridlighton Lawn Tennis Club Membership Confirmation * I AM A CURRENT BRIDLIGHTON CLUB MEMBER. I UNDERSTAND THAT INCORRECT DETAILS MAY LEAD TO APPLICATION DENIAL AND LOSS OF BLTC BENEFITS WITH ROMITA TENNIS. NO I AM NOT A BLTC MEMBER. Thank you!
