Queenstown Tennis Club

Junior Club Registration 2011/12

Register using the online form below, or

Download, complete and post to Queenstown Tennis Club, P O BOX 1019, Queenstown 9348

Registrant Details

First Name *

Surname *

Date of Birth (dd/mm/yyyy) *

Top Dog #

Contact phone number *

Player Type *

Girl
Boy

Club Events

If you are interested in playing in any of the club events shown below, please tick the appropriate box and your entry will be forwarded automatically to the organisers of those competitions.

Additional Junior Member Registrants

Add a second Junior member

First Name

Family Name

Date of Birth (dd/mm/yyyy)

Top Dog Number

Contact phone number

Player Type

Girl
Boy

Add a third Junior member

First Name

Family Name

Date of Birth (dd/mm/yyyy)

Top Dog #

Contact phone number

Player Type

Girl
Boy

Parent / Guardian Contact Details

Parent or Guardian Name *

Contact Email *

Contact phone number *

Postal Address *

Junior Members Joining

1 Junior Member $50
2 Junior Members $90
3 Junior Members $120

Payment Type *

Direct Online Banking
Cheque

Direct Banking Details

Queenstown Tennis Club Inc ASB Queenstown Account number 12 3234 0099799 00 Please put your name & “Junior sub” in ref fields

Cheque Payment Details

Cheques should be made out to Queenstown Tennis Club and can be posted to PO Box 1019, Queenstown. Once your subscription payment has been received, you will be posted your club membership tag, new gate key code and Members Handbook.

* I have read and agree to the Queenstown Tennis Club Rules

and Club Membership Declaration