August 7-10, 2017 - Robinson ISD

ROBINSON “END OF SUMMER” TENNIS CAMP Summer Jr. Development Director: Coach Jack Gregory

Assistant: Coach Jodi Olson

Helping Take Robinson Jr Tennis to the Top

August 7-10, 2017 GROUP I –

(MON-THU) at the RHS Tennis Center

GROUP II – COST: $50

COST: $45

Entering 1st – 5th grades

Entering 6th – 9th grades

TIME: 8:30 – 10:00 a.m.

TIME: 10:00 a.m. – 12:00 p.m.

2 or More Siblings Registered: $40 Each (Maximum $100 per family) Please complete a separate registration form for each child attending.

$30 each for children of RISD Faculty/Staff (make note on registration form) Each player will receive a camp t-shirt and certificate of participation. A limited number of rackets will be available for use.

Parent/Guardian is employed by RISD:

_____YES

Campus: ________________________________

CHILD’S NAME: ______________________________________

AGE: _____________

PARENT/GUARDIAN: ______________________________________________

GRADE:

MALE

FEMALE

_______________ ENTERING IN FALL 2017

ADDRESS: _____________________________________________________

circle one:

GROUP I

GROUP II

CITY: ____________________________ PHONE: ____________________EMERGENCY PHONE: ___________________ EMAIL: ____________________________________________________________________ CHOOSE T-SHIRT SIZE (circle one): youth med

youth lg

ADULT:

SM

MD

LG

XL

Make check payable to and mail to: Jack R. Gregory 610 North Ave N Clifton, TX 76634

MEDICAL RELEASE: I give my child permission to participate in the Robinson Tennis Summer Junior Development Program under the direction of Jack Gregory. I agree to assume any and all liability and hold Mr. Gregory and any assistant instructors harmless from all claims or actions which I or my child ever had, now have, or may have in the future or any liability for injuries or damages which occur to my child or me as a result of his/her participation in this program. I waive all claims for medical expenses that may occur as a result of accidental injury. In case of injury I give my permission, if I cannot be contacted, for Jack Gregory or his representative to obtain medical services for my child if the injury is deemed an emergency. MY CHILD IS ALLERGIC TO: _______________________________________________________________________________ AND HAS THE SPECIAL MEDICAL CONDITION OF: __________________________________________________________ ____________________________________________________________________________________________________________ ________________________________________________ PARENT/GUARDIAN SIGNATURE

_________________ DATE