Kids-Luv-Tennis Fall 2019 Registration

Kids-Luv-Tennis Fall 2019 Registration
Player/Student *

First Name Last Name
Parent(s) Name(s) *
E-mail *
Emergency Phone Number #1 *

Area Code Phone Number
Emergency Phone Number #2

Area Code Phone Number
School *
Gender *

Male Female
Student Age *
Grade *
Teacher
Racial Background (for statistical use only) *
T-Shirt Size *
KLT Program *

New Player Returning Player
My child attends after-school care *

Yes No

Required Participation Forms
Participation and Medical Release
- I hereby voluntarily permit my child to participate in the Kids-Luv-Tennis program. I understand and fully accept that there are risks involved in sports, and that accidents and injuries are common and ordinary occurrences of sports. I agree that in the event of an emergency injury or illness, the staff member in charge may act on my behalf and at my expense in obtaining medical treatment for my child. Every attempt will be made to call the emergency number contact before treatment.
Participation and Medical Release *

Yes No
Media Release
- I give permission for my child to be photographed for print, video or electronic imaging which is for the use of SSTA. I understand that the images may be used in print publications, presentations, websites and social media. I also understand that no royalty, fee or other compensation shall become to me by reason of such use.
Media Release *

Yes No
Payment

Each new player receives a child-size racquet and a team t-shirt.
Registration Fee *

$125 Scholarship; family is enrolled in Free/Reduced lunch program
Scholarship families pay $25
Payment Options *

Paypal Check Cash
Please make your CHECK payable to Sandy Springs Tennis Association or SSTA for the amount due of your family rate. Please mail all checks to 8343 Roswell Rd. Ste. 185, Sandy Springs, GA 30350. No Player will not be accepted into program until payment is made.
To submit CASH, contact Dianna Dummitt at sandyspringscta@gmail.com to make arrangements. Player will not be accepted into program until payment is made.
Paypal

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USD Registration Fee
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Kids-Luv-Tennis Fall 2019 Registration

Required Participation Forms

Payment