tennis registration and credit authorization form sign up early to

AT THE LINDERO COUNTRY CLUB
TENNIS REGISTRATION AND CREDIT AUTHORIZATION FORM
SIGN UP EARLY TO SECURE A SPOT. SPACE IS LIMITED.
CLINIC SCHEDULE
MO
Match Ready
Ages 6–up (1.5 hrs)
(Only 20 Spaces Available per Day)
TU
WE
4:30 pm
6:00 pm
Tournament Training
Ages 8-up (1.5 hrs) – COACH APPROVAL
(Only 8 Spaces Available per day)
TH
FR
4:30 pm
6:00 pm
4:30 pm
6:00 pm
4:30 pm
6:00 pm
4:30 pm
6:00 pm
Student Name:
Age:
Date of Birth:
Parent/Legal Guardian’s Name(if applicable):
Parent/Legal Guardian’s Name(if applicable):
Address:
City:
Home Phone:
Cell Phone:
Email:
School (if applicable):
Zip Code:
Medical Conditions:
Known Allergies:
COST PER SESSION:
(SAVE MORE MONEY WHEN YOU REGISTER)
MATCH READY / TOURNAMENT TRAINING PRICING
MONTHLY BILLING (Credit Card Registration)
$20 per class
SELECT CLASS:
□ Match Ready
□ Tournament Training
SELECT DAY/DAYS ATTENDING:
Monday
Tuesday
Wednesday
Thursday
Friday
SELECT FORM OF PAYMENT (Please fill out completely)
CREDIT CARD**
ON FILE
DAILY DROP IN RATE* (Cash or Check)
$25 per class
CIRCLE ONE:
CARD NUMBER:
VISA
EXP:
DROP IN INFORMATION*
DROP INS WILL ONLY BE AVAILABLE IF THERE IS SPACE
CLASSES WILL BE CAPPED
YOU MUST SIGN UP FOR THE SESSION TO SECURE A SPOT FOR CLINIC
Monthly Billing charges occur on the last day of each month**
MASTERCARD
AMERICAN EXPRESS
CVV#:
CHECK
CHECK #
NAME ON CREDIT CARD:
CASH
BILLING ADDRESS:
BILLING ZIP CODE:
SIGNATURE:
DATE:
I authorize Match Tough Tennis Academy to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods and services
described above, for the amount indicated above only, and is valid for one time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit
card company; so long as the transaction corresponds to the terms indicated in this form.
Located at the Lindero Country Club
5719 Lake Lindero Drive, Agoura Hills, CA 91301
Email: [email protected]
Website: www.matchtoughtennisacademy.com
Phone: Jordan – (805) 657-2228
Phil – (818) 288-4580