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Summer Tennis Camps
@ lee graham pool Register by June 1 for $10 discount! Camp Weeks run June 22 – August 28, 2015 Ages 5 & up Tennis Courts @ Lee Graham Pool 7319 Lee Highway | Falls Church, VA 22042 TWO GREAT OPTIONS!!
Option #1 – Three‐Hour Camp ✣ Mon‐Thurs ✣ 9:00 am – Noon $195 Lee Graham Members / $220 Non‐Members per week Option #2 – 90‐Minute Clinics ✣ Mon‐Thurs ✣ 9:00‐10:30 am OR 10:30 am‐Noon $120 Lee Graham Members / $140 Non‐Members per week Priority given to Lee Graham Swim/Dive Team Members Week #1: Week #2: Week #3: Week #4: Week #5: June 22‐25 June 29‐July 2 July 6‐9 July 13‐16 July 20‐23 Week #6: Week #7: Week #8: Week #9: Week #10: July 27‐30 August 3‐6 August 10‐13 August 17‐20 August 24‐27 Additional Camp Opportunity
** Tennis & Golf Camps ** 2 days of tennis ✣ 2 days of golf Driving range, with 9 real holes of golf included. Offered two weeks ONLY: July 27‐30 OR August 17‐20 9:15 a.m. – 3:00 p.m. Limit of 6 students | $330 Lee Graham Members/$350 Non‐Members per week Early registration, multiple week, and siblings DISCOUNTS!
For more information contact Chris Canepa of C.O.R.E. Sports at 703‐946‐5256or [email protected]. 2015 REGISTRATION FORM
Please send completed registration form and check made payable to CHRIS CANEPA to: 20852 Trinity Square | Sterling, VA 20165 | 703‐946‐5256 | [email protected] Player's Name _______________________________________ DOB __________________ Parent / Guardian ____________________ Home Phone _________________________ E‐mail Address _______________________________________Cell Phone(s) _________________________ Address _______________________________ City ______________State ______________ Zip _________ Signature ___________________________________________ Date ________________________________ If you are signing up for a clinic, please indicate what time (9:00 or 10:30). Also be sure to deduct your discounts – For Camps: $10 discount for registering by June 1, $10 discount for multiple weeks, $10 discount for multiple siblings For Clinic: $5 discount for registering by June 1, $5 discount for multiple weeks, $5 discount for multiple siblings Week June 22‐25 June 29‐July 2 July 6‐9 July 13‐16 July 20‐23 July 27‐30 August 3‐6 August 10‐13 August 17‐20 August 24‐27 TOTAL 90‐Minute Clinic $120 members; $140 non‐members Camp
$195 members; $220 non‐members
Tennis & Golf Camp
$330 members; $350 non‐members Discount(s) Total for Week
+ Medical Information and Release +
Allergies, injuries, medical conditions or health factors which may inhibit or limit player's activity: ________ ________________________________________________________________________________________________ Player's Physician ___________________________________ Physician's Phone ______________________________ Insurance Policy ____________________________________ Policy Number _________________________________ Emergency Contact _________________________________ Relationship ___________________________________ Phone Number _____________________________________ Signature __________________________________________ Date _________________________________________ MEDICAL AUTHORIZATION When the emergency contact or I cannot be reached, I give my consent and permission for the above named doctors to provide medical attention to my child. In the event that the doctors listed above cannot be contacted or in the event of an emergency, I give any licensed physician, dentist, hospital or health care provider consent to perform emergency medical treatment at my expense as deemed necessary for the well‐being of my child. This may include transportation to the nearest emergency room. RELEASE In consideration of making facilities and/or services available, I do hereby for and on behalf of myself and my heirs and legal representatives release and forever discharge C.O.R.E. Sports LLC. and its owners, manager and representatives from any and all claims and demands of every kind, nature and character which I, or my child, may have or hereafter acquire for any and all damages or losses which may be suffered or sustained by me, or my child, in connection with our activity, and all such claims are hereby waived and released.