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SUMMERcamp
CAMP 2016
REGISTRATION
Summer
2016
re g i st rat i o n
11 WEEKS OF SUMMER CAMP

JUNE 6 - AUGUST 26, 2016

DOB:

Player Name:

Age:

Player Email:

Returning Player: (circle one) YES NO

Player Cell:

Grade Level:

School:

Gender: M / F
PARENT/GUARDIAN INFORMATION

Parent/Guardian 1 Name:

Relation:

Email:

Cell:

Home Address:
Parent/Guardian 2 Name:

Relation:

Email:

Cell:

Home Address:
Insurance Provider (REQUIRED):

Policy #:

Insurance Primary Name:

Group #:

TENNIS EXPRESS

______

$750

1 Week Full Day

______

$600/wk

Multiple weeks (4 or more)

______

$400

1 Week Mornings only

______

$85/session

Drop-in

______
______

$250
$60/session

Weekly Sessions

(Early or Late Morning)

Drop-In

Custom:

Dates of Attendance:
TOTAL PRICE:

PAYMENT INFORMATION
Card Type (circle one): MasterCard

Visa

American Express

Name on Card: __________________________________________

Exp. Date: ________________

Card Number: ___________________________________________

Security Code: _____________

Billing Address:
Street: ______________________________________________________________________________
City, State: ____________________________ Zip Code: ____________ Country: _________________
I authorize ATA / GSI to charge my credit card according to the terms outlined above. This payment authorization
is for the goods/services described above for the amounts indicated only. I certify that I am an authorized user of this credit card.
Please note: All payments made via credit card will accrue a 3% convenience fee.

Parent / Guardian Signature: _____________________________________ Date: __________________

PHOTO RELEASE
PHOTO
release
PHOTO CONSENT: ATA/GSI is proud of our students tennis and academic achievements and we request permission to
announce those achievements via various forms of media.

Check here if you give permission to ATA/GSI to use photos of your son/daughter to appear on our website, social
media, and related marketing materials, including but not limited to publications and advertisements for ATA/GSI.

Signature of Parent/Guardian: _________________________ Date: ________________

(Required if Player is under 18 years old)

TERMS AND
TERMS
& CONDITIONS
CONDITIONS

By registering for any Advantage Tennis Academy / Grand Slam Institute ("Academy") program, the Player and his/her Parents /
Guardians hereby agree to the following. Player and his/her Parents and/or Guardians must indicate their agreement to abide by
these terms by signing in the area below, or Player participation will not be allowed:
PAYMENT INFORMATION:
1. Tuition payments, administrative fees, incidental charges and other charges (hereinafter collectively "fees") are set forth on this
"Registration Packet" which shall be filled out and signed by the Player and his/her Parents and/or Guardians in conjunction with this
Agreement. Said Registration Packet is hereby incorporated into this Agreement by reference. Players may not be allowed to
participate in Academy Programs when any fees are outstanding by ten (10) days. Any fees ten (10) days past due shall be subject
to a 5% late fee. Fees thirty (30) days past due shall be subject to a 10% late fee, which rate shall continue to accrue until fees are
paid in full. If accounts are not brought current within sixty (60) days, said accounts shall be submitted to a collection agency. Player
and/or Parents/Guardians shall be liable for all costs.
2. Player and his/her parents and/or guardians hereby authorize direct deposit and/or automatic billing of the credit card on file for
Players fees required on the Payment Worksheet. Additional incidental fees shall be billed and collected prior to departure.
REFUND & CANCELLATION POLICY:
All payments are non-refundable. No refunds shall be given for injury or sickness; however, a Player may receive up to 30 days of
credit to be applied to future attendance at the Academy in the event of sickness or injury. All sickness and/or injury must be
evidenced by a written notice, signed by a licensed physician, and delivered to the Academy within ten (10) days. Cancellation of
private lessons requires 24-hour notice, without which will result in full charge of the applicable lesson fee. No refunds will be given
for cancellation of sessions due to weather; however, attendance may be made up by attending future sessions. Please contact the
Academy for rescheduling.
DRESS CODE & STANDARDS:
Player shall wear "proper tennis attire" and display his/her "best behavior" at all times when at a tournament or at The Tennis Club
at Newport Beach Country Club "TC". Player shall follow all TC of Irvine rules and regulations at all times when at the club. If Player
damages any property of the Academy, TC, or another player, Player shall reimburse the damaged party in full within two (2) days
of the incident. The Academy reserves the right, at any time, to expel an athlete/student who does not display the quality, standards,
and integrity of its program. Player agrees to abide by the ATA Honor Code and all specific rules set out by ATA. Player
understands that, in case of violation, the Academy reserves the right to enforce disciplinary action, which may include suspension
or expulsion without refund. Player and Parent/Guardian understand that drug and/or alcohol testing may be administered, and
consent to such testing if deemed necessary by the Academy staff.
LOST OR STOLEN PROPERTY:
Player and their Parent/Guardian release the Academy, its agents, owners and employees from any claims for lost or stolen articles,
money, or other valuables that may occur during the players stay or attendance at the Academy and at tournaments or other
locations. Player and their Parent/Guardian hereby assume full responsibility, financial or otherwise, for any such loss.
RELEASE OF LIABILITY:
I understand that injuries may occur as a result of training, conditioning, and/or playing tennis or other sports while the previously
named Player is participating in Academy activities. We hereby release and indemnify the Academy, TC, their sponsors, and any of
their partners, members, directors, employees, instructors, and agents from any and all liability relating to any accidents or injuries
incurred while said Player is participating in Academy activities and programs, whether or not these activities and programs occur at
the Academy or TC, Academy provided housing, off-site, or during travel.
MEDICAL INSURANCE:
Player and their Parent/Guardian agree to have medical insurance prior to start of program until completion of the program.
Evidence of current policy must be presented prior to attending program and a copy will be kept on file.

We hereby agree to fully abide by the Advantage Tennis Academy's "Terms & Conditions."

Signature of Parent:

______

Print Name:

Date:
If the Player does not adhere to the above, the Academy reserves the right to terminate Player's privileges at the Academy, and
Player and his parent/guardian shall immediately make arrangements for the Player's departure. NO refunds will be given for
termination.