Make Checks Payable in amount of: $20 Made out to: Humboldt

HumboldtTennisClub
TournamentRegistration
ParticipantInformation
FirstName:__________________________________________________________________________________
LastName:___________________________________________________________________________________
DateofBirth:__________________Age:_______School:__________________grade:______________
StreetAddress:_____________________________________________________________________________
City:______________________State:_____________
Zip:_____________________
CellPhonefortournamentinfo(_________)_________-____________
Contactcellphonenumberforupdatesduringtournament.
USTAorUTRPlayerLevel_________PlayerlevelonSchoolLadder:_____________
Coach’sName________________________________Coach’sPhone:______________________________
Coach’sEmail:_________________________________________________
ParentcontactInformation-
Name:________________________________________
Email:______________________________________________________
HomePhone(_________)___________________-_____________________
CellPhone(__________)_______________-___________________________
MakeChecksPayableinamountof:$20
Madeoutto:HumboldtTennisClub
Emailto:[email protected]
Dropoffat:HitsandKicks853HStreet(OnthePlaza)
TournamentDirector:
Peter(textorcall707.616.4781)
MedicalReleaseForm
LIABILITY/MEDICAL RELEASE
Player’s Name:_____________________________________ Date of Birth:__________
EMERGENCY INFORMATION
Parent/Guardian Name:____________________________________________________
Home Ph:____________________ Work Ph:_________________________
Parent/Guardian Name:___________________________________________________
Home Ph:____________________ Work Ph:_________________________
Allergies:____________________________________________________________
Other Medical Conditions:________________________________________________
Medical Insurance Company:_____________________________Phone:_____________
Policy Holder:_________________________ Policy Number:______________________
Player’s Physician:________________________________Phone:___________________
In an emergency, when parent/guardian cannot be reached, please contact:
Name:___________________________________Home Ph:_____________Work Ph: _______________
Name: __________________________________Home Ph:_____________Work Ph: ________________
PLAYER OR PARENT/GUARDIAN AGREEMENT
I, as the adult-age player or the parent/guardian of the registered, minor player, agree to abide by the rules
of the Humboldt Tennis Club, USTA and its affiliated organizations and sponsors. Recognizing the
possibility of physical injury associated with tennis and in consideration for the Humboldt Tennis Club and
USTA accepting the player for its tennis programs and activities, I hereby release, discharge and/or
otherwise indemnify the Humboldt Tennis Club, USTA and its affiliated organizations and sponsors, their
employees and associated personnel, including the owners of courts and facilities utilized for the programs,
against any claim by or on behalf of the registrant as a result of the registrant’s participation in the program
and/or being transported to or from the same, which transportation I hereby authorize.
Adult Player or Parent/Legal Guardian of Minor Player
(Print) Name:___________________________________ Date:_______________________
Signature:_________________________________________________
CONSENT FOR MEDICAL TREATMENT
As the adult player or parent/legal guardian of a minor participant in Humboldt Tennis Club/USTA
programs, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of
Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to
preserve the life, limb or well being of the player.
Date:________________________ Signature:_________________________________________
Emailto:[email protected]
Mailto:HumboldtTennisClub:600FStreetSte.3#820Arcata,CA95521
AnyQuestionscallPeterat707.616.4781
TOURNAMENT INFORMATION
@humboldtTennisClub on Facebook
Location: Arcata High School
Information:
Level-Based Draw means…
MORE CLOSE MATCHES = MORE FUN!
Your placement in a level-based draw will be based on your ability
(not age or gender biased). That means good fun, competitive play
for the beginner or advanced. You will get a set number of matches
in a draw that will increase the likelihood that you have matches
both good for your development and good for your opportunity to
improve your level. Minimum number of matches for each player
in this tournament: 3 (hopefully we will average around 6 matches
each!)
FORMAT: Level-based Round Robin
The tournament has the flexibility to format match, set and game
scoring to best fit the number of players and courts to give players
the most amount of matches possible.
• 8 game pro set or best of 3 sets match(no add scoringTBD).
• Minimum 3 matches
• Players can expect to play in a round robin style group with
other players at a similar level.
• Results in the group play will guarantee the most competitive
in final grouping and ranking in future Tournaments. In other
words if your matches are close you will stay at a similar
level… if your matches are not close you will move to a more
competitive level… CLOSE MATCHES = MORE FUN!
Coaching:
Coaching may be allowed by a Tournament Director approved coach
and after signing a coaching agreement. Coaching can happen at
changeover, within the regular pace of play and without verbal
interruption. Parents may not coach unless they are a regular staff
member at one of the represented clubs or school teams.
IMPORTANT:
The Tournament Director will make every effort to place players in
draws that are beneficial for the player.
Tournament Director: Peter Dauphinee 707-616-4781