Junior Tennis Camp
2012 Application		P.O.Box 621
Kingston, Ontario K7L 4X1
Tel. (613) 542-2467
www.kingstontennisclub.com
Name (participant) *  * Emergency Contacts & Information:
Date of Birth *  Contact 1:
T-shirt size *  Tel (H) (W)
Parent/Guardian *  Contact 2:
Address *  Tel (H) (W)
Ontario Health Card:
E-mail *  Doctor:
Telephone *  



Doctor's Phone#

Are the parent(s)/camper members at KTC in 2012? ** Yes   No
Junior Tennis Camp



Week Session:
 Full Day
lunch included;
Member - $220;
NonMember $240
Ages 7-17
 Morning Session
or Afternoon
Member - $120
NonMember $140
Ages 5-17
 Lunch
($35)		 Before/After Care ($30)
8AM-9AM or
4:30PM-5:30PM
Before   After		 Total
1: July 3-6 (4 days)
 Yes   No AM  PM
2: July 9-13
 Yes   No AM  PM
3: July 16-20
 Yes   No AM  PM
4: July 23-27
 Yes   No AM  PM
5: July 30-August 3
 Yes   No AM  PM
6: Aug 7-10 (4 days)
 Yes   No AM  PM
7: Aug 13-17
 Yes   No AM  PM
8: Aug 20-24
 Yes   No AM  PM
9: Aug 27-31
 Yes   No AM  PM
 Total: $    
4-day SHORT WEEKS: $25 is deducted from the regular rate; $5 each for Lunch & Supervision.
** Member rates are for campers who are members or whose parent(s) are members

Please list any medical conditions of which we should be aware that may make the participant more prone to illness or injury:
Please note any food-related or other relevant allergies here:

NOTES: We strongly recommend SUNSCREEN and HATS for all participants. SHOES WITH NON-MARKING SOLES ARE REQUIRED.

Every effort will be made to protect the health and safety of the participants through the supervision and training of staff. Sport activities may include a variety of appropriate activities relevant to learning tennis. ALL CAMPS WILL BE HELD RAIN OR SHINE, with suitable indoor activities planned for rainy days. Rarely, some activities may be held at alternate indoor/outdoor facilities, and the participants will walk to and from other locations under the supervision of the instructors.

SPACE IS LIMITED – REGISTER EARLY TO AVOID DISAPPOINTMENT. PAYMENT MUST ACCOMPANY REGISTRATION FORM (POST-DATED CHEQUES ACCEPTABLE, BUT DATE MUST BE 10 DAYS BEFORE SESSION START OR EARLIER)

* I acknowledge that the Kingston Tennis Club assumes no responsibility for accidents or illness due to the nature of the activities.

I allow inclusion in camp photos: Yes  No ___________________________________________ Signature of Parent / Guardian

KTC REFUND POLICY:
   1. Only requests for refunds received in writing at KTC at least 10 days before the start of the program will be reimbursed,
       less a $35 admin fee/unit.
   2. During a session, refunds may be issued for the remaining days of that session for certified medical reasons only.
   3. Authorised refunds will be issued by cheque only and mailed to the applicant within 30 days of request.