Future Stars Tennis Camp at Green Hollow Tennis Club
(Please print and complete all items)

Name _________________________________________________
Address (Winter) ________________________________________
City__________________________State______Zip_____________
Sex______Birthdate _________________Age as of 6/1__________
School _____________________________Grade fall 2005_______
Home Phone (Winter)_____________________________________
Mother Name/Business Phone______________________________
Cell Phone (mother) ______________________________________
Father Name/Business Phone _______________________________
Cell Phone (Father)_______________________________________
E-mail address __________________________________________
Summer Address ________________________________________
City_________________________State______Zip______________
Summer Phone__________________________________________

Camp Sessions (please select below) 6  □ July 18 - 22
1 □ June 13 - 17 7  □ July 25 - 29
2 □ June 20 - 24 8  □ Aug 1 - 5
3 □ June 27 - July 1 9  □ Aug 8 - 12
4 □ July 4 - 8 10 □ Aug 15 - 19
5 □ July 11 - 15 11 □ Aug 22 - 26
□ Lunch $45/week □  Transportation $125/week

2-4 Weeks = $550 per week            5-11 Weeks=$525 per week

To Register Future Stars requires a $250 per week deposit.
Enclosed is my payment of ________________ Check#____________
□ Am Ex   □ Visa      □ MC      _________________________________Exp. ______

Mail to:   Green Hollow Tennis Club
                PO Box 1118
                East Hampton, NY 11937
                Fax to: (914) 273-8506


As an applicant, I hereby accept the conditions of membership and agree to participate. I agree to comply with all program regulations, and hereby remove Green Hollow Tennis Club, Inc., staff, management, and Future Stars from all liability or damages incurred while involved in this program. Future Stars Tennis LLC., retains the rights to any photographs taken at the camp to be used for publicity or advertising.

Signature____________________________________Date_____________