CENTRAL TEXAS TENNIS ASSOCIATION
REGISTRATION
Name:
Age:
Date of Birth:
School:
Grade:
Gender:
Phone (H):
(W):
Other:
Home Address:
City / State / Zip:
Email Address:
Contact the following in case of an emergency:
Name:
Name:
Number:
Number:
Relationship:
Relationship:
Performance Level:
CTTA Offer:
- Certified Professional Tennis Instructors
- All staff and volunteers certified in CPR & First Aid
- All equipment provided
- Session / Program Tournaments
- Family Day Picnic
- Tutoring and Mentoring
- Math, Reading, Science, and Arts & Craft program
1. Does your child require special care or any disabilities?
2011 Medical Information & Waiver Form
If yes, please specify:
If yes, please specify:
If yes, please specify:
If yes, please specify:
If yes, please specify:
2. Is your child currently taking any prescribed medication?
3. Does your child have an existing or previous illness?
4. Has your child been hospitalized in the past 12 months? 
5. Does your child have any known allergies to foods, insect stings or medications?
In consideration of myself or my child, being allowed to participate in the program sponsored by CTTA I, the undersigned parent, binding heirs, executors, administrators, estate and assigns, do hereby release and agree not to hold liable the CTTA and/or its officers, agents and employees; from any and all actions causes of action, claims, demands, costs or damages as a result of property damages or personal injuries or death sustained by me or my said child or his/her or my property, arising from or resulting from an act or omission, negligent or otherwise, of CTTA, programs, its officers, agents and employees or any other person or at any participant in the program while participating in the said activity or while traveling to or from the place at which such activity will be conducted
-- Consent is hereby given for the applicant to participant in CTTA programs and permission is given for any emergency medical treatment, operation, or anesthesia, which might become necessary. I agree to be responsible for the expense of medical treatment of service.
Child's Name:
Physician Name:
Physician's Telephone:
-- I do not give consent for any emergency medical treatment, operation, or anesthesia, which might be deemed necessary. I agree to be responsible for all outcomes due to my decision. (Applicant may still participate in CTTA programs.)
Additional Information or Phone
CTTA is a non-profit 501c3 organization
© Copyright 2006. All rights reserved. Central Texas Tennis Association
For more information, contact CTTA at (512) 280-5800
6-Week Clinic
Fees vary per site. Call (512) 466-6545 for details
Registration Open
Tuesday
Northwest Park 10 and Under 6:15 pm - 7:15 pm
Wednesday
Northwest Park Homeschoolers 9:30 am - 1:30 pm
Thursday
Northwest Park 10 and Under 6:15 pm - 7:15 pm
Covington Middle School Evening Clinic 7:00 pm - 8:00 pm
Friday
Northwest Park Advance & Team Tennis 6:30 pm - 8 pm
Dick Nichols Park Homeschoolers 10:00 am - 12:30 pm
Turner Roberts Rec. Center Tennis Clinic 3:30 pm - 5:30 pm
North West Park Evening Clinic 7:00 pm - 8:00 pm
Saturday
West Austin Athletic Club Open Clinic 10:00 am - Noon
Anderson High School Afternoon Clinic 3:00 pm - 4:00 pm
West Austin Athletic Club Tennis (M & W)
Clinic 1 : Age 4 - 8 3:30 pm - 4:30 pm
Clinic 2 : Age 9 - 18 4:30 pm - 6:00 pm
(visit WAAC for fees & registration)
Day:
Time:
Location:
Day:
Time:
Location:
Day:
Time:
Location:
Clinic Selection:
