HPTA - Training Sign-up

Training Sign-up

To sign up for training at HPTA, please first arrange for a try-out to establish the correct level of training. The try-out is not needed for overseas players and may be waived by Ashley. Following the try-out, complete the forms below for online training sign-up and medical history.

Once you have completed the sign-up, please complete the player goals form on our Setting Goals page and the questionnaire on our New Player Questionnaire page.

HPTA Training Sign-up

Please note that all fields followed by an asterisk must be filled in.

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address*
Street Address*

City*
City*

State/Prov

Zip/Postal Code

Country

Home Phone*
Home Phone*

Cell/Other Phone

Date*
Date*

Date of Birth*
Date of Birth*

Parent/Guardian Names*
Parent/Guardian Names*

Section Ranking*
Section Ranking*

Ranking Age Group*
Ranking Age Group*

Try-out*
Try-out*

	Done try-out
	Waiting for try-out
	Try-out waived by Ashley
	Overseas player

Training Program
No partial refunds if withdraw during month*

	Academy: 2x/wk ($290/mo)
	Academy: 3x/wk ($380/mo)
	Academy: 4x/wk ($450/mo)
	Elite: 2x/wk ($290/mo)
	Elite: 3x/wk ($380/mo)
	Elite: 4x/wk ($450/mo)
	Full Time
	10 and Under: 1x/wk ($40/mo)
	10 and Under: 2x/wk ($70/mo)
	10 and Under: 3x/wk ($100/mo)

Preferred Days
Academy = Mon - Thurs
10 & Under = Tues - Thurs*

	Monday
	Tuesday
	Wednesday
	Thursday
	Friday

Training Start Date*
Training Start Date*

Tournaments*
Tournaments*

I commit to play tournaments to the recommended schedule.
(Elite: 2+ per month and 70% of Elite Calendar, Academy 1+ per month).

PACT Agreement*
PACT Agreement*

	Player: I have read and agree to the Agreement
	Parent: I have read and agree to the Agreement

Terms and Release*
Terms and Release*

	Player: I have read and agree to the Training Terms & Release
	Parent: I have read and agree to the Training Terms & Release

Medical History and Release

Player name*
Medical History and Release

Player name*

Sex*
Sex*

Age*
Age*

Height*
Height*

Weight (lbs)*
Weight (lbs)*

If the player should be restricted from any activity, please note

If player will be taking medication during training, please indicate name of drug and dosage

Indicate any medical condition or history requiring special attention

Immunizations - check those up to date*
Immunizations - check those up to date*

	Measles
	Polio
	Rubella
	Tetanus Toxoid
	Tuberculin Test

Illnesses*
Illnesses*

	None
	Asthma
	Chicken Pox
	Diabetes
	German Measles (Rubella)
	High Blood Pressure
	Measles
	Mumps
	Pneumonia

Allergies*
Allergies*

	None known
	Asthma
	Eczema
	Hay Fever
	Insect Stings
	Other (please state below)

Other Allergies

Drug Reactions*
Drug Reactions*

	None known
	Antibiotics (name below)
	Penicillin
	Sulfa
	Other (name below)

Drug reaction additional information

Physician name*

Physician name*

Physician address*
Physician address*

Physician phone*
Physician phone*

Health insurance carrier*
Health insurance carrier*

Policy number*
Policy number*

Policyholder name*
Policyholder name*

Policyholder DoB*
Policyholder DoB*

Hobson Performance Tennis Academy
100 Countryside Place
Lawrenceville
Georgia, 30043
(404) 374-9750