School Break Camp Registration

In addition to filling out this form, email or bring the school break camp medical form.

    First name *

    Last name *

    DOB *mm/dd/yyyy

    Gender *

    Address *

    City *

    State *

    Zip Code *

    Parent's name *

    Email *

    Home phone

    Cell phone *

    Emergency contact *

    Relationship *

    Phone *

    Camp dates are coming soon

    Years of tennis experience:

    Playing level:BeginnerIntermediateAdvanced

    Going to buy lunch at YTA? *YesNo

    How did you find out about YTA?

    Refund Policy
    Before 1st of June refunds are available upon request.
    After 1st of June refunds are given for medical reasons with doctor's note only.

    Parental/Guardian Agreement:

    I hereby grant permission for my son/daughter to participate in Youth Tennis Academy summer tennis program. I agree that my son/daughter will abide by YTA Summer Program Plan and Policies, and I realize that any breach of conduct may result in expulsion from the summer program without refund. Before 1st of June refunds are available upon request. After 1st of June refunds are given for medical reasons with doctor's note only. I hereby agree to the payment schedule and refund policy. I agree not to leave my son/daughter on YTA premises while dropping him/her off without making sure that there is direct supervision by an authorized representative of YTA. I authorize YTA or its authorized representatives to administer medical treatment to my son/daughter at their discretion, and in case of emergency to place my son/daughter, at my own expense and without further consent, in a hospital for medical service and treatment, or if no hospital is not readily accessible, to place my child in the care of a licensed doctor for treatment. I hereby agree to release, discharge and hold harmless Youth Tennis Academy and its employees from all causes, liabilities, damages, claims or demands whatsoever on account of any injury or accident involving my son/daughter in the course of activities held in connection with the summer program. I agree that the YTA may use photographs and video of campers for any lawful purpose, including but not limited to publicity, illustration, advertising and web/social media.

    The Management reserves all the rights including the right to accept or deny the application for the summer program.

    I have read the above agreement and I accept its terms.

    The YТА Management reserves all the rights

    All payments should be
    mailed by check to 309 SW 47th Street, Cape Coral, FL 33914,
    or Zelle at 617-4802971,
    or over the phone by card.