Media Recreation Summer Tennis Program
Registration Form
** Please complete all information and return payment to:
Media Borough Recreation Dept.
301 N. Jackson Street
Media, PA 19063
** Registration and payments must be received before start of clinic. Space is limited.
Please indicate your program registration.
Children/Young Adult Camp is the weeks of
August 22 and August 29:
7-11 yr. old - 9-10am
12-16 yr. old - 10-11 am
The session is from Monday-Friday.
$10 a week for Borough residents.
$20 a week for Non-Borough residents.
Tennis balls provided. Please bring rackets.
_____________________________________________________________________
Registration Form (please print and fill out completely)
Name ________________________________________
Address ______________________________________
Email Address_________________________________
Phone Number ________________________________
Emergency Contact Name and Phone Number
_____________________________________________
□ 7-10 Yr. Old Youth
August 22
□ 11-15 Yr. Old Youth
August 22
□ 7-10 Yr. Old Youth
August 29
□ 11-15 Yr. Old Youth
August 29