Mashantum Tennis Club • PO Box 125, Dennis, MA 02638

Mashantum Tennis Club

2011 Lesson Application

Name Age Ladder 6/27 7/4 7/11 7/18 7/25 8/1 8/8 8/15 8/22

Parents’ name:      

Email:      
Cell phone:      

Signature:       Date:      

Please send application and check for 50% deposit made out to Mashantum
Tennis Club:
Mashantum Tennis Club
PO Box 125
Dennis, MA 02638

If you have not done so already, please fill out this online form (http://eepurl.com/csESj)
with your contact information to assure receiving Mashantum updates and dues
information.

Email: wes@mashantumtennis.com Website: www.mashantumtennis.com

 Mashantum Tennis Club • PO Box 125, Dennis, MA 02638

Waiver and Release

By signing this Waiver and Release, you and your family agree that you may be giving up legal
rights and remedies available to you and/or your family. Read and complete this document
carefully. Contact an attorney if you have any questions.

NAME OF CHILD/CHILDREN:      

NAME OF PARENT (S) / GUARDIAN (S) /      

ADULT MEMBER:
EMERGENCY CONTACT PERSON:      

For value received, I/we agree on behalf of myself/ourselves, my child/children, named herein,
my/our heirs, successors, guests and assigns, that I/we assume all risks and waive any liability of
any nature whatsoever against and agree to indemnify and hold harmless the MASHANTUM
TENNIS CLUB, INC., its officers, directors, members, employees and agents (“CLUB”) with
respect to any and all actions, claims or demands that may be made or brought on my/our behalf
against said CLUB, its officers, directors, members, employees and agents in connection with
my/our child’s/children’s participation in the lesson program and my/our/ their playing or
watching tennis or related activities, or utilizing any of the land (including coming to or leaving
the Club property), buildings, equipment, furniture, fixtures and facilities of said Club, for
personal injuries or property loss or damage. THIS WAIVER AND RELESE SHALL ALSO
EXTEND TO THE DENNIS CONSERVATION TRUST AND ITS TRUSTEES.

I/we have fully read and understand the Waiver of Release, and its terms and conditions, and
freely and voluntarily agree that it is binding upon me/us, my/our child/children and our heirs,
successors, guests and assigns. Further, I/we understand and agree that this Waiver and Release
shall remain in full force and effect for so long as any member of my/our family shall be a
participant in or a member of said Club and/or its program and activities.

Signed this day: 2/6/2011

           
___________________________________ ___________________________________
Parent/Guardian Parent/Guardian

Email: wes@mashantumtennis.com Website: www.mashantumtennis.com