Application for Youth Platform Tennis Clinic
Membership (Ages 17 and Under)

Youth Platform Tennis Clinic Membership

Parent Name

Date required

Number of Youth Applicants

(1) $100 Annual Facility Fee + Tax = $108.38 - $108.38

(2) $100 Annual Facility Fee + Tax = $216.75 - $216.75

(3) $100 Annual Facility Fee + Tax = $325.13 - $325.13

Youth Applicant 1 Name

Youth Applicant 1 Date of Birth required

Youth Applicant 2 Name

Youth Applicant 2 Date of Birth

Youth Applicant 3 Name

Youth Applicant 3 Date of Birth

Parent Email Address

Parent Cell Phone (XXXXXXXXXX)

Home Address

City

State

Zip Code

Home Phone (XXXXXXXXXX)

How did you hear about Pound Ridge Tennis Club?

Additional Notes (If Applicable)

We agree that if accepted for membership, we will comply with the rules, regulations, and bylaws of the Pound Ridge Tennis Club.