Junior Coaching Booking Form

Junior’s Name / Age / DOB / Course details (day/time) / Member Y/N / £ Course Fee

Please pay course and membership fees via BACs as detailed below. Please reference you payment with the Junior’s surname followed by either coaching or membership.

Payments / Account name / Sort Code / Account Number / Paid Y/N
Please pay course fees via BACs / Josh Woodward / 11-03-22 / 00307557
Pay membership fees via BACS / Haslemere Tennis Club / 00390461 / 20-31-06

Please provide full contact details of a parent/guardian to be used in case of an emergency:

Name
Relationship to Child
Mobile Phone Number
Home Phone Number
Home Address
Email Address

Please give details of any medical conditions we should be aware of e.g. asthma, diabetes, allergies. This information will be treated confidentially and only used if your child is unwell or involved in an accident while at the club.

Parent/guardian declaration

I agree to the child listed above taking part in the general activities of the Club and that he/she has agreed to follow the rules of the Club and Junior Charter. To the best of my knowledge, he/she has no medical conditions that could affect his/her safety at the Club, other than those declared on this form. I understand that in the event of any injury, illness or other medical need, all reasonable steps will be taken to contact me and to deal with the situation appropriately.

I understand that I must inform the Club of any changes to the information provided on this form.

Signed ……………………………………………………………… Date ………………………………..

Please print name ……………………………………………………………………………………….

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Photography Consent

Haslemere tennis club takes its responsibilities for the safety and wellbeing of all of its members seriously and is acutely aware of child protection issues. As such we follows the LTA’s published guidance on photography and video footage, full details can which can be viewed on

From time to time the club will take photographs of players and events for use the club’s website and also to promote the tennis club to a wider local audience via the local press. We recognise that there is a balance between the low risk of misuse and the very positive effects good photography can have for both junior members and the club.

Our photography and use of images policy includes: -

  • Children will be made aware that photographs may be taken and how images will be used.
  • We will only take images which are appropriate and considered safe from misuse.
  • Children will not be named alongside their photograph.
  • No single image will be used without consent.
  • Event organisers will challenge any unauthorised person taking photographs.
  • Parental /legal guardian consent will be sought prior to their child to be photographed and/or images used on promotional material.

I have read Haslemere Tennis Club’s “photography and use of images policy” and agree to images being taken of my child and used on Haslemere Tennis Club’s promotional material, newsletters and website.

Name of child …………………………………………………………………………………………………………………………………….

Name of parent / legal guardian………………………………………………………………………………………………………..

Signature of parent / legal guardian………………………………………………………… Date……………………………

You can withdraw your consent at any time by contacting the Membership Secretary.