2021 Registration Form

Kincardine Tennis Club (KTC)–2021 Membership Registration form

NAME (Print)

EMAIL (Print)

TELEPHONE

Landline:

Cell:

ADULT MEMBERSHIP:   ________  FEE   $ 50    JUNIOR ( 18 or under):   ________  FEE  $ 15

Family – $100 Includes 2 adults and all children 18 and under. _____

Waiver

Please complete the following waiver declarations:

  1. I understand that choosing to attend and/or participate at the KTC involves risks, including without limitation, bodily injury or harm and contracting or disseminating COVID-19. I acknowledge that I am participating voluntarily.  I freely accept and fully assume any and all risks. I release the KTC and its directors, officers, and representatives from any and all potential claims or liabilities related to my attendance and/or participation at the KTC.

Yes    No

  1. I declare that I will not enter the Kincardine tennis courts if I or anyone in my household has experienced any cold or flu-like symptoms in the previous 14 days (including, without limitation, fever, cough, headache, sore throat, respiratory illness, or difficulty breathing);

or if, I have been in close contact with anyone with flu-like symptoms or acute respiratory illness in the past 14 days.  Yes   No

  1. If I, or anyone in my household experience any cold or flu-like symptoms or receive positive test results for COVID-19 after submitting this Waiver, I will: (a) immediately inform the President of the KTC; and (b) not visit the KTC until I receive clearance to do so from a qualified medical professional, or fourteen (14) days after the cold or flu-like symptoms have completely gone away, whichever is later. Yes   No

 

  1. I, on behalf of myself and each member of my immediate family under 18, hereby agree that any false statements made in this Waiver or any failure to abide by the above noted requirements may lead to disciplinary action, which may include restriction of privileges, suspension of membership or expulsion from the KTC. Yes   No

MEMBERSHIP SIGNATURE

DATE

Tennis Play during Covid-19

Players are to maintain a minimum 6 foot (2 meter) distance from each other unless they live under the same roof.  See KTC website, Etiquette and Covid Safety Plan page for further details.

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