.

Name*

Age on June 1st*

Address*

Parents Name*

Primary Phone Number*

Emergency Contact*

Emergency Phone Number*

Email*

Are there any medical issues we should be aware of?*

Yes
No

If Yes, Please Describe

Did you attend a JNCC camp last year?*

Yes
No

How Did You Hear About Our Camp?*

Google or other search engines
Facebook
Email
Yelp
Friend or Family Referral
Club Advertisement (flyer, poster etc)
Activity Hero
www.cliffdrysdale.com
Club website
Other

CAMP OPTIONS

Are You A Chateau Elan Tennis Member*

Yes
No

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Coupon Code

Registration Fee

$1.00

Total

$1.00

Terms*

Liability Disclaimer: In consideration of Cliff Drysdale Management , Allowing my child's/children's participation in the camp, I for myself and my child/Children release Chateau Elan racquet Club and Cliff Drysdale Management and its partners and affiliated officers, directors, agents and employees from and waive all claims, damages, and liabilities whatsoever for property damage or loss, personal injury or death arising from or in connection with my child's/children's participation in the camp. Cliff Drysdale Management retains all rights to any video and photographs taken at the camp to be used for publicity or advertising.

I have read and agree to the terms above.

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