LGTA JUNIOR ACADEMY REGISTRATION
Player's Name
Birthdate
Parent's Name(s)
Phone Number
Address
Phone Number 2
 
Email Address
 
School Attending
 
Tennis Experience
 
JUNIOR ACADEMY FALL 2011 PRACTICE SCHEDULE (Starts August 27)

Regular Clinic Practices:
Fridays, 3:30-5:30 p.m. at Blossom Hill Park
Saturdays, 4:00-6:00 p.m. at Los Gatos High School
Junior Academy Day Pass
(2 Hour Jr. Academy Practice)
$30
Junior Academy 10-Pack
(20 Hours of Jr. Academy Practice)
$250

 

DISCOUNTS		  

Sibling Discount*: 50% Discount
*Discount applicable only if players participate in the same LGTA program.
   
TOTAL DUE:   
*Please make checks payable to Todd Dissly Athletics LLC and bring to Head Pro Caryn Cranston at the courts.
Indemnity Agreement
The undersigned in consideration of participation in this program agrees to indemnify and hold harmless Los Gatos Tennis Academy and Todd Dissly from any and all liability for any injury which may be suffered by the above named individual registered in this program, arising out of, or in any way connected with, participation in this program. By signing below, I represent that the participant is in good condition and has no impairment or ailment that would prevent or make it medically unwise for this person to participate in this program. I have read the above application and agreement, and fully understand that I assume all risks for any injuries received.
I have read and agree with the terms of this agreement.