Junior Name *

First Name

Last Name

Junior's Date of Birth *

MM

DD

YYYY

Elie Sports Club Member *

Yes

No

Parent/Carer

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact *

First Name

Last Name

Emergency Contact Mobile *

(###)

###

####

Select Your Age Category and Ability

Ages 4-6 Beginner from 8:30-9:30am

Ages 7-10 Beginner from 10:00-11:00am

Ages 7-10 Intermediate from 11:00am-12:00pm

Ages 11-14 Beginner/Intermediate from 12:30-1:30pm

Ages 11-14 Advanced from 1:30-2:30pm

Select Your Camp Week

First come first serve basis.

Monday 1 July to Friday 5 July

Monday 8 July to Friday 12 July

Monday 15 July to Friday 19 July

Monday 22 July to Friday 26 July

Monday 29 July to Friday 2 August

Monday 5 August to Friday 9 August

Does your child have any pre-existing medical conditions that may effect the child’s participation in sport or activities provided?

Please Select Yes or No. If Yes Please Provide Details.

YES

NO

Does your child have any existing injuries?

Please Select Yes or No. If Yes Please Provide Details.

YES

NO

Does your child have any allergies?

Please Select Yes or No. If Yes Please Provide Details.

YES

NO

Do you give permission for your child to be included in photographs or video?

Please Select Yes or No.

YES

NO

Do you give your permission for Elie Sports Club to contact you and your child from time to time via email, text or social networking platforms?

Please Select Yes or No.

YES

NO

I acknowledge that Elie Sports Club (ESC) is not responsible for providing adult supervision for my child except during official ESC tennis and padel camps, coaching and competitions. *

Yes

Todays' Date of Application *

MM

DD

YYYY