Adult Programs

Winter Session 2012

 

Members receive a 10% discount.

Beginner adult classes include a Wilson® graphite racquet. 

 

 

 

ADULT REGISTRATION FORM WINTER SESSIONS 2012

Name: __________________________________Home #: __________________

Work #:___________________________Cell#:________________________________  

Email:_______________________________________________________

Home Address: ___________________________   City ____________________    

Postal Code ___________Health card:__________________________

Any Health Conditions/Allergies:________________________________

 

 

Please check the program(s) you would like to register for:


 

 

 

Media Consent:

I give consent and permission for Lakewood Indoor Tennis Centre to photograph and/or record my tennis activities for educational and promotional purposes.

Signature ______________________________Date_____________________________                                           


               


Cancellation: Cancellations must be requested in writing, one week prior to the first day of the program for a refund and will be subject to a $25.00 administration fee. No other refunds will be given unless accompanied by a medical certificate. LITC reserves the right to cancel any session; in this instance a full refund will be given.

Release, Warrant and Indemnity: In consideration of the acceptance of the application for enrolment of the participant named above, I for myself and (if applicable) on behalf of the participant I release, waive and discharge LITC and its agents, servants, contractors, representatives, successors and assigns of all claims, demands, and damages, costs, expenses, actions and cases of actions whether in law or equity, in respect of death, injury, loss or damage to my person or property or to the Participant howsoever caused.

I further undertake to hold and save harmless and agree to indemnify the Releases from and against any and all liability incurred by any or all of them arising as a result of or in any way connected to the participation of the participant in the LITC program. I warrant the Participant is physically fit to participate in the LITC program.

 

I acknowledge having read, understood and agree to the above Release, Warranty and Indemnity

 


Signature: _______________________Date: ___________________________

 

 

Office use only:

Program payment Total amount including GST:_________________________________________________

Method of Payment ( ) VISA ( ) MC ( ) CASH ( ) DEBIT ( ) CHEQUE

Received by: ____________________________________ Date:____________________________________