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Website Home
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PRINCE GEORGE'S TENNIS & EDUCATION FOUNDATION, INC.
2009-2010 REGISTRATION FORM
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Junior
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Adult
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Name: Participant #1
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Female
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Male
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Date of Birth
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School:
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Name: Participant #2
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Adult
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Junior
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Female
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Male
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Date of Birth
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School:
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Parent's Name:
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Address:
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City:
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Zip:
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State:
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Work:
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Cell:
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Phone, Home:
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Email:
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Emergency Contact Name:
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Medical Conditions
(i.e. allergies,
respiratory, visual, etc.
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Phone:
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WAIVER
I, the undersigned, on behalf of myself, my heirs, my executors and administrators do fully and forever discharge the Prince George’
s Tennis & Education Foundation, Inc. (the “Foundation”), the Maryland National Capital Park & Planning Commission and/or their
owners, shareholders, directors, employees, volunteers, agents, or affiliates (collectively, the “Foundation Affiliates”) from any and
all damages, liability, demands, or claims for loss or damage resulting from or arising out of my or my child(ren)’s participation in
any and all sessions or programs offered by the Foundation or use of facilities or equipment provided by the Foundation Affiliates
and/or any injury or damage which may be sustained by me or my child(ren) while participating in any session of the Foundation’s
programs. I also consent to allow medical treatment of myself and/or my child(ren) in case of an emergency and agree to be fully
responsible for payment of any and all fees incurred as a result of necessary medical treatment. Registration, participation or
attendance in any program constitutes permission to be photographed for possible publicity, promotional or media purposes and
constitutes a waiver of any claims for compensation from all sponsoring agencies.
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Place Initials in box to accept conditions of waiver.
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Signature of Parent
or Guardian:
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Date:
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If you would like to pay by credit
card, click the PayPal button below
to complete your registration.
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