Wait List - Tompkins NEW Student Registration
Welcome to Kings County Tennis League! Please fill out this form to join the wait list for Tompkins Tennis Club. All classes are held in the Tompkins Houses Courtyard (105 Tompkins Ave,, Bed-Stuy, Brooklyn) unless otherwise specified.
Student's First Name *
Your answer
Student's Last Name *
Your answer
Gender *
Please select one
Student's Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian Name *
Your answer
Parent/Guardian Email Address *
Your answer
Are you interested in joining a committee of parents led by our Program Manager? *
Street Address *
Ex.123 Main Street, Apt 15
Your answer
Parent/Guardian Primary Phone Number *
(123) 456-7890
Your answer
Parent Guardian Secondary Phone Number
(987) 654-3210
Your answer
Do you and/or your child(ren) live in Tompkins Houses? *
If "No," do you and/or your child(ren) live in a NYCHA housing development other than Tompkins?
If "Yes," to the above, provide the name of the development here.
Your answer
Which category describes your annual household income? *
How many members are a part of your household? *
Child's Race/Ethnicity *
Emergency Contact Name *
This should be someone other than the parent/guardian listed previously.
Your answer
Emergency Contact Phone Number *
(123) 456-7890
Your answer
Emergency Contact's Relationship to Student *
Your answer
Does the student have any food allergies? *
If yes, what food is your child allergic to?
(If no, leave blank)
Your answer
Are there any other medical conditions you think we need to be aware of?
Your answer
Will your student attend the Tompkins Play Day (optional demo/intro class) on Saturday, May 13 at Tompkins Courtyard? *
Uniform Size *
How did you hear about us? *
If you selected "Other" above, please explain.
Your answer
Please check the box below to signify your agreement with the KCTL Student Release Form and Liability Waiver: https://drive.google.com/file/d/0B0Vuk8XcPJqqUjBtSnhXZE1CdUE/view *
Required
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