Orange Hunt Tennis Presents
Fall 2014 After-School Junior Tennis Programs
Nine-Week Session Beginning Tuesday, September 9th
Jump Start for Kids Ages 4-8
Ball tracking, striking and movement skills for junior ages 4-8
Clinic
Day
Start
Time
End
Time
Start
Date
End
Date
Clinic
ID #
# of
Weeks
Tuesday
4:30 PM
5:30 PM
09/09/14
11/04/14
1
9
Sunday
3:30 PM
4:30 PM
09/14/14
11/09/14
2
9
Fee
(1 Clinic/Week)
$162 permanent
$180 associate
$162 permanent
$180 associate
Fun and Fundamentals for Juniors Ages 9-18
Introductory and foundation skill development for juniors ages 9-18
Clinic
Day
Start
Time
End
Time
Start
Date
End
Date
Clinic
ID #
# of
Weeks
Tuesday
5:30 PM
7:00 PM
09/09/14
11/04/14
3
9
Sunday
4:30 PM
6:00 PM
09/14/14
11/09/14
4
9
Fee
(1 Clinic/Week)
$234 permanent
$257 associate
$234 permanent
$257 associate
Register Information
Name:
Clinic ID #
Date of Birth:
Address:
City:
State:
Phone:
Email:
Parent Signature:
Zip:
Please make check out to: Orange Hunt Swim & Tennis Club and mail with this registration
form to: Tonja Romero
6601 Red Jacket Road Springfield, VA 22152
*** Arrange make ups for rain outs with coach (Coach will email if a rain out occurs)
***No refunds
*** Registrations must be received by Friday, September 5, 2014
Tennis Instruction Agreement
* This form must be completed before commencing ANY tennis instruction or related activities.
Release and Waiver
For and in consideration of R.U.N Tennis, LLC permitting me to enroll in and participate in the tennis instruction and related activities
(collectively, the “Activity”), by signing below I hereby voluntarily indemnify, release from liability and hold harmless R.U.N Tennis, LLC
and its owner(s), agent(s) and contractor(s) for any accident, injury, illness, death, loss, damage to person or property, or other
consequences suffered by me or any other person arising or resulting directly or indirectly from my participation in the Activity.
If I am injured, I agree to assume any financial obligation, either through my personal health insurance, or through some other means,
for any medical costs, which I incur. R.U.N Tennis, LLC assumes no responsibility for any medical expenses, injury, or damage suffered
by Participant in connection with the use of any R.U.N Tennis, LLC facilities or services in connection with the Activity (regardless of
where such services take place).
I further agree to conform to all rules and regulations adopted by R.U.N Tennis, LLC and/or any other facility at which the Activity takes
place (e.g., tennis clubs, etc.)
IT IS MY INTENTION BY SIGNING BELOW TO EXPRESSLY ASSUME ALL RISK OF PERSONAL INJURY, DEATH, OR PROPERTY
DAMAGE UPON MYSELF, TO THE EXCLUSION OF R.U.N Tennis, LLC, AND TO EXEMPT AND RELIEVE R.U.N Tennis, LLC FROM
LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH. IF INSTRUCTION IS PROVIDED AT A
PRIVATE RESIDENCE, I AGREE TO HOLD THE OWNER OF SUCH RESIDENCE AS WELL AS R.U.N Tennis, LLC AND ITS
INSTRUCTORS AND OWNER(S) ADDITIONALLY HARMLESS FROM ANY LIABILITY, LOSS OR DAMAGE ARISING AT SUCH
RESIDENCE.
I agree that neither I nor my spouse, assignees, heirs, guardians, and/or legal representatives will make any claim against, sue or
attach the property of R.U.N Tennis, LLC and/or any owner or agent thereof, for any loss or damage resulting from my participation in
the Activity.
I AM AWARE OF THE POTENTIAL DANGERS INCIDENTAL TO THE ACTIVITY, THAT THIS IS A RELEASE OF LIABILITY, A
WAIVER OF MY LEGAL RIGHT TO COLLECT DAMAGES IN THE EVENT OF INJURY, DEATH OR PROPERTY DAMAGE AND A
CONTRACT BETWEEN MYSELF AND R.U.N Tennis, LLC, AND I VOLUNTARILY SIGN THIS DOCUMENT.
_____________________________________________
Participant's Name
_____________________________________________
Date (MM/DD/YYYY)
_____________________________________________
Address
_____________________________________________
City
_____________________________________________
State
_____________________________________________
Zip
_____________________________________________
Telephone
_____________________________________________
Email
_____________________________________________
Emergency Contact’s or Parent’s/Guardian’s Name/Telephone