Midtown Tennis Club Junior Program Enrollment Fall 2021/Winter 2022. Completed form required for each child.
Semester 1: September 13, 2021-January 21, 2022 (17 classes)
Midtown Tennis Club
341 8th Avenue at 27th Street
212-989-8572 ext 6
Jennifer: midtowntennisnyc@gmail.com
Player Last Name *
Player First Name *
Player Age *
Player Birth Date *
Player Level *
Parent Name *
Parent Phone (xxx-xxx-xxxx) *
Parent Email *
Street Address *
Apartment Number
City *
State *
Zip Code *
Emergency Contact Name *
Emergency Contact Phone (xxx-xxx-xxxx) *
First Request for Day *
Second Request for Day *
Request for Time *
Special Requests (ie, pro, grouped with another child)
Fee Schedule (17 classes) *
Name on Credit Card *
Credit Card Number (xxxx-xxxx-xxxx-xxxx) *
Credit Card Expiration Date *
Credit Card Security Code *
Credit Card Billing Zip Code *
Liability Waiver and Assumption of Risk Release
By checking the box below, I agree that I am the parent or legal guardian of the player named in this registration form and will abide by all rules and regulations set forth by Midtown Tennis Club. I acknowledge that there are inherent dangers associated with playing tennis and Midtown Tennis Club, its executives, officers, agents and employees, shall not be liable for any personal injuries, property damage or other losses sustained while on the property of Midtown Tennis Club, due to negligence or otherwise. I further declare that the player named is physically sound and not suffering from any illness, disease or impairment which would prevent his/her participation in the program. In the case of accident or injury to the named player, and the parent or emergency contact is not available, I grant permission to Midtown Tennis Club to obtain medical attention, if necessary, for which I will be financially responsible. I understand and agree that Midtown Tennis Club retains the rights to any photographs and/or videos taken of me and/or the named player at Midtown Tennis Club to be used for Midtown Tennis Club advertising, social media, marketing and publicity. There are no refunds, transfers, credits available for this enrollment.

I Agree to the Liability Waiver and Assumption of Risk Release Above. Please sign below. *
Terms and Conditions
1. All players must wear smooth soled sneakers. No running, treaded or other footwear will be permitted.
2. All players, families and guests must follow all safety protocols as outlined on our website.
3. Player coordinator reserves the right to move players to the appropriate court based on level.
4. There will be one make up allowed for the semester with a scheduled absence.
5. Make-ups are not guaranteed and may only be scheduled within the semester registered.
6. Program will run all weeks, except for Winter Break, December 20-31 2021, and Thanksgiving Day, November 25, 2021.

I Agree to the Terms and Conditions Above. Please sign below. *
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