Player Name *

First Name

Last Name

Are you already a Power Point player?

Yes

No

Parent/Gaurdian Name *

First Name

Last Name

Phone *

(###)

###

####

Prior tennis experience:

Check all that apply

Private lessons

Indoor clinics

Summer lessons

Summer Programs

Do you play on a school tennis team?

Yes

No

Photographic Release *

The above named participant and his/her legal guardian grant full permission for MOVTA to use, duplicate, broadcast, and/or publish photographic images for the purpose of promoting the Power Point Tennis program.

I agree.

Participation Release *

I give my permission for the above-named child to participate in this Power Point Tennis program. It is clearly understood and agreed that MOTVA, any program sponsor, and/or all persons connected with the program will not be held responsible in the event of injury to the above-named child. In the event of injury, I hereby agree to allow pertinent medical information about the above-named participant to be shared with any medical professional that may treat or respond if an injury occurs.

I agree.