2022 NJTL Summer Program Level 3

Registration Level 3

Date: June 6 to July 14, 2022

Classes meet Monday, Tuesday, & Wednesday

Match Play events will be held on Thursdays at various locations



Level 3 Summer Program*

Player Information

Child’s Name*
Shirt Size*
DOB*
Gender*
Player's Ethnicity: (this is for grant purposes & is optional)
Does your child qualify for a free or reduced fee lunch at school? (optional)
Has this player previously played in an NJTL tennis program?*
Have you applied for or will you be applying for a scholarship to assist with registration fees? (MUST ANSWER TO CONTINUE.)*

Please call Tyler in our office at 317-429-9965

Mandatory Participation Consent

I, individually, for my child, and for my child’s other parent or guardian voluntarily and knowingly assume any and all risk of loss, damage to my child’s person or property, property loss, injury (including death), both foreseen and unforeseen, arising out of or related to my child’s attendance at and participation in the 2022 National Junior Tennis & Learning (NJTL) of Indianapolis Summer Tennis Program, from any cause whatsoever, including the fault or negligence of Releasees (as defined below). I, for myself, for my child, for my child’s other parent or guardian, my heirs, my personal representatives and assigns do hereby release, waive, discharge and covenant not to sue USTA/National Junior Tennis and Learning, NJTL of Indianapolis, the Consolidated City of Indianapolis/Dept. of Parks & Recreation, Lawrence Township, Decatur Township, Perry Township, Pike Township, Wayne Township, MSD of Warren Township, Franklin Township Community School Corporation, City of Beech Grove/Beech Grove Parks Department/Beech Grove High School, Marian University, Community School Corporation Of Southern Hancock County, Greenfield-Central Schools, Northwestern Con School Corp and Indianapolis Public Schools, IRC East, Carmel Racquet Club, UIndy Tennis Center, West Indy Racquet Club (collectively “Releasees”) their respective officers, directors, employees and volunteers from all liability, loss, claims, demands, possible causes of action, court costs, settlement costs and fees, attorneys fees and any other expenses arising from any claim or lawsuit that may arise from any loss, damage or injury (including death) to my child or my child’s property resulting from or arising in connection with, or related to, my child’s attendance at or participation in the 2022 NJTL of Indianapolis Summer Tennis Program. In the event that my child is injured, I hereby consent to the provision of necessary and appropriate emergency medical treatment. 

Photo consent: By providing my signature, I hereby irrevocably and absolutely consent to and authorize the use, reuse, publication, republication, and editing (for any purpose whatsoever, including without limitation, illustration, promotion, advertising, and trade in any medium – print, electronic, or otherwise), by the National Junior Tennis & Learning of Indianapolis (its assigns and anyone authorized by the National Junior Tennis & Learning of Indianapolis) of any and all photographs and video footage (along with reproductions and/or derivative works) of me and/or my child and which may contain me and/or my child’s name, voice, signature, photograph, image, likeness, distinctive appearance, gestures, and/or mannerisms, all without further compensation to me or my child. Such use, reuse, publication, republication, and editing may be in whole or in part, severally, or in conjunction with other photographs and video footage. 

Agree to Consent*
Parent/Guardian Name*
Use your mouse or finger to draw your signature above

COVID-19 Assumption of Risk and Waiver of Liability

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many instances, governed and/or issued guidelines for the congregation of groups of people.

National Junior Tennis and Learning of Indianapolis (“INDY NJTL”) has enacted measures and adopted plans to reduce the risk of spreading COVID-19; however, the INDY NJTL cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending programming administered by INDY NJTL could increase your risk and your child(ren)’s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by participating in programming administered by INDY NJTL and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 during programming administered by INDY NJTL may result from the actions, omissions, or negligence of myself and others, including, but not limited to, the INDY NJTL employees, volunteers, and program participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at INDY NJTL events or during participation in INDY NJTL programming (“Claims”).

On my behalf, and on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless INDY NJTL, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the INDY NJTL, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any INDY NJTL programming.

On my behalf, and on behalf of my child(ren), I hereby acknowledge that all participants, instructors, and parents will be expected to exercise social distancing and abide by the requisite COVID-19 policies provided by the CDC and the State of Indiana. I promise that if I, my child(ren), or anyone they have been in contact with is exhibiting or has recently exhibited COVID-19-like symptoms, I will refrain from sending my child(ren) to Indy NJTL programming.

Agree to Waiver*
Parent/Guardian Name*
Use your mouse or finger to draw your signature above

Contact Information

Parent/Legal Guardian Information
Please complete the following information about the player's parent or legal guardian.
Parent/Legal Guardian Name*
Address*

Emergency Contact Information

​Check the box below if the parent information is the same as the emergency contact information.
Name

PAYMENT

Name on Card*
Billing Address*