2009 Membership Application
Personal Information
Family Name: _______________________ Telephone #:____________________
Address: __________________________________ Postal Code: ______________
Email:_____________________________________________________________
* Email will be the means of communicating important Club Events and restricted court
times, so be sure to include your email address.
Membership Information Junior (age < 18)
$20 ( ) Adult - $25 ( )Family (max. 5) - $45 ( )
Adults (all family members except Juniors)
Date of Birth
Juniors Name (Juniors are 18 years & younger)
Date of Birth
Activities
Junior lessons - $36 ( ) Tuesday PM House League - $10 ( ) Adult Lessons - $36 ( )
Durham C - $20 ( ) Tuesday AM Ladies League - $10 ( ) Adult Ladder - $10 ( )
Junior-Senior Tournament - $10 ( ) Mixed Doubles Tournament - $10 ( )
Junior Ladder – ( ) Junior House League - ( )
Key Deposit - $3 ( ) No charge if you return last years key.
Important: Participation in any leagues or activities requires a membership.
Cheques made payable to “Amberlea Tennis Club”
Paid by Cash ( )
Cheque ( )
Amount: ____________________ Cheque #______
Mail or drop the completed application, with payment, to: Amberlea Tennis Club,
c/o Colleen Miles, 658 Aspen Road, Pickering, ON L1V 3Y9, Phone # 905-421-9089
(Don’t forget key deposit or last years key)
Visit www.amberleatennis.ca
Or email: [email protected]
The undersigned hereby released and forever discharges Amberlea Tennis Club, its membership, executive officers,
instructors and the City of Pickering from any and all actions, causes of actions, claims and demands, for damages, loss
and/or injury, howsoever arising, whether the result of bodily injuries, illness, or death to person, or loss or damage to
personal property which heretofore may have been or may hereafter be sustained by the undersigned as a consequence
of direct or indirect participation in or at any tennis related activity and consequences thereof.. I have read and
understood the above release/disclaimer.
G I would like to share my email and mailing address with the OTA to receive OTA information.
Signed:___________________
Date:______________________