2012 Summer Tennis Camp Registration
Please print and mail the following information and all checks to (and payable to):
Andy Harader
19 Colton Court
Redwood City, CA 94062
Weeks (circle weeks attending)
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Cost
| One Week rate $310 |
Two Week rate $560 |
Three Week rate $800 |
| Daily rate $70 | *4th July Week $250 | **PAUSD
Campers Pro-rated |
How You Heard of Us: (circle one)
| PA Daily | PA Weekly | Google Ads | other |
| PalyLink | Banner | Word of Mouth | Internet |
Student Information
| Student's Name: | ____________________________________________________ |
| Student's Grade & Age: | ____________________________________________________ |
| School Attending: | ____________________________________________________ |
| Tennis Experience: (circle one) |
beginner, intermediate, tournament player, ranked tournament player |
| Parent's Name: | ____________________________________________________ |
| Home Phone: | ____________________________________________________ |
| Cell Phone: | ____________________________________________________ |
| Home Address: | ____________________________________________________ |
| Email Address: | ____________________________________________________ |
| Weeks Attending: | ____________________________________________________ |
| How you heard of us: | ____________________________________________________ |
| Amount Enclosed: | ____________________________________________________ |
Cancellations:If you have to cancel and do so in writing by May 15 (please send to the above address or contact me here), a full camp credit valid for any of the appropriate camps that are not filled to capacity will be issued for this and next summeer. The camp credit is transferable to a family member only. No cash refunds. Thank you.
Waiver of Liability: By signing below, student/parent understands and accepts that he/she or their child who is named above is taking tennis lessons at his/her own risk. Student/parent hereby expressly waives any claim of liability against Andy Harader, Andy Harader Tennis Camp, their agents and contractors for any negligence, personal injury, premises liability or other damages which occur to student during the above described tennis lessons. This waiver is a complete release of any responsibility for injuries or damages sustained wether or not the student was engaged in playing tennis at the time of the injury.
Signiature: _______________________________________________ Date: _______________