Junior Program APPLICATION Form 2020-21 Winter Student's Name *
First Last Birthdate *
Date Format: MM slash DD slash YYYY Age * Gender * Parent Information Parent's Name *
First Last Parent's Email Address * Home Phone * Parents's Mobile Phone Parent's Office Phone Address * Potomac Swim & Tennis Club Member *
Program Information Cancellations/Withdrawals must be received prior to the start of the program and are subject to a $50 service charge. If a student cancels/withdraws due to injury, illness or any other reason after the start of the program, NO REFUND will be issued. NO REFUND will be given for missed classes. Winter: October 20th - April 9th All Non-members must have a PSTC annual Tennis Visitors Pass (TVP). (Member Price/Non-member Price)
Tennis Visitors (TVP) are NOT members, they are registered visitors, and must select the NON-MEMBER price options.
Junior Program Options 4 STAR KIDS: Ages 12 & under. The focus is on player development, using a modified ball and specific techniques in learning the game of tennis. 4 STAR KIDS ~ Winter BEGINNER / INTERMEDIATE: Ages 11-14. At the Beginner/Intermediate level, the program’s goals are to teach boys and girls ages 11-14 basic tennis skills and strategies in a fun, encouraging and enthusiastic environment. Emphasis is placed on developing tennis skills, along with confidence and a positive attitude. BEGINNER / INTERMEDIATE ~ Winter DEVELOPING TOURNAMENT: Ages 9-14. This is an intensive program for Intermediate and Advanced boys and girls ages 9-14. The training is devoted to instructional sessions on court, physical conditioning to develop strength and speed, extensive drilling to sharpen all strokes, and competitive play. DEVELOPING TOURNAMENT ~ Winter YOUNG TOURNAMENT: Ages 9-14. Our Young Tournament Players are highly competitive juniors ages 9-14 who are currently ranked in the top 75 (in BG12s and BG14s) and top 10 (in BG10s) in USTA/MAS rankings. Classes will emphasize drills, match play, mental training and physical fitness. The goal of this program is to take already competitive juniors and fine-tune their playing skills. YOUNG TOURNAMENT ~ Winter HIGH SCHOOL VARSITY: Ages 13-18. This program consists primarily of players who are currently on their High School Varsity team along with players who would like to improve their tennis skills. HIGH SCHOOL ~ Winter Medical Authorization & Release Student Name *
First Last Student Condition * Date of Medical Authorization *
Date Format: MM slash DD slash YYYY
By dating above & signing below, in an emergency, when I/we cannot be contacted, I/we hereby authorize the staff of the 4 Star Tennis Academy to take my/our child to the emergency room of the nearest hospital. I/we authorize that hospital and its medical staff to provide treatment deemed necessary for the well-being of my/our child.
Parent/Guardian Signature for Medical Authorization * Date of Parent Release *
Date Format: MM slash DD slash YYYY
By dating above & signing below, I agree to hold the 4 Star Tennis Academy and Bullis School harmless for injury or loss that may occur as a result of my participation in 4 Star activities.
Parent/Guardian Signature for Release * Assumption of Risk Waiver * Cancellation Policy * Permission for Photo Use *
I give permission for photos of my child participating in 4 Star Tennis at Bullis programs to be taken and used for the 4 Star Tennis Website and/or Facebook page. We understand that if students are identified, only their first names will be used.
Additional Information (optional)