RACQUETEERS

APPLICATION FOR 2011-2012 ANNUAL DUES & FALL 2011 SESSION

NAME: __________________________________________

ADDRESS: ________________________________________

CITY, STATE, & ZIP: _________________________________

PHONE – HOME: _______________________ CELL: ___________________________

E-MAIL: __________________________________________

__ Check here if you do NOT want your name and personal information to be on the membership directory list. The list will be distributed to Racqueteers members only.

__ Check here to be a substitute, not a regular Sunday night player.

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_____ANNUAL Dues: $20.00

_____Regular play (eight alternating Sundays beginning September 11th) $140.00

TOTAL $______

Please write checks payable to “Racqueteers” and mail to:

Racqueteers Tennis

c/o Dave Fitzgerald

2444 W. Estes

Chicago, IL 60645

Questions? Call Heidi @ 312-961-5676 or e-mail to hamcat@hellokitty.com

=========================Liability Waiver=======================

I hereby agree that Racqueteers and its officers and representatives shall not be liable, jointly or severally, for any injuries to my person or property. I also agree to indemnify and hold harmless the parties from and against any and all action, claims, demands, liability, loss, damage, and expense of any kind, including attorney’s fees, arising from such claims.

I am aware and familiar with the ordinary and hazardous risk involved in tennis, or other sports and non-sport activities, and I understand that I am assuming those risks.

I am 21 years of age or older, and will only engage in activities in which I am physically fit to participate.

Please sign and date to indicate that you have read and agree to the terms stated above.

Signed_________________________________________ Date ______________________________