Junior Academies - Radley Run Country Club

2017 Junior Paddle Registration


Student's Name:*
Age:*
Date of Birth:*
Email:*
Cell Phone Number:*
Select Your Member Category:*
Member Number:*
Select the times you are available to play:*
Monday:
Tuesday:
Wednesday:
Thursday:
3:30 to 4:30:
4:30 to 5:30:
5:30 to 6:30:
Preferred Partner (Not Required):
Preferred Courtmates (Not Required):

Long Sleeve t-shirt:*	Please indicate shirt size
Comments:

Primary E-mail:*	Confirmation will be sent to this address.
Membership Number:*	Non-Members type, NA into box
Membership Category:*
Child's First Name:*
Last Name:*
Gender:*
Enroll For:	Golf
Enroll For:	Tennis
Enroll For:	Swim Team
Child's Birthday (xx/xx/xxxx):*
Shirt Size:*
Please list any medical conditions, to include food allergies:
Emergency Contact Information
Check this box and skip this section:	If you have already completed this section for another child.
First Name:
Last Name:
Relationship to Child:
Preferred Emergency Contact Phone Number:	()-First three digitsSecond three digitsLast four digits
Cell Phone:	()-First three digitsSecond three digitsLast four digits
Home Phone:	()-First three digitsSecond three digitsLast four digits
Street Address:
City/State/Zip:
Allergies and/or Medical Concerns:
Junior Golf Enrollment Information (only complete if Jr. is enrolled in golf)
Would your Jr. like to participate in Chesco Days ($25 additional fee):
How many holes:	5 Holes 9 Holes 18 Holes Tiger Cubs
Marshal June 16:	Yes No Maybe
Marshal June 23:	Yes No Maybe
Marshal June 30:	Yes No Maybe
Marshal July 7:	Yes No Maybe
Marshal July 14:	Yes No Maybe
Marshal July 21:	Yes No Maybe
Marshal July 28:	Yes No Maybe
Marshal August 18 - Skills:	Yes No Maybe
Name of Marshal:
Jr. Tennis Enrollment Information (only complete if jr. is enrolled in tennis)
Class Level:	Level 6: Little Tennis (ages 5-6) Level 5: Beginner (ages 7-8) Level 4: Intermediate (ages 9-10) Level 3: Intermediate (ages 11-12) Level 2: Advanced (ages 11-12) Level 1: Teen Level (ages 13-18) High Performance (ages 13-18)
Swim Team Enrollment Information (only complete if Jr. is enrolled in swimming)
I have read the Code of Ethics:	This Code of Ethics is a written contract between the swimmers, coaches, and parents to abide by the rules and regulations of the sport and uphold the ideals of fair play and sportsmanship. Each person associated with a Chester County Country Club Swim League (CCCCSL) team is accountable for his/her own behavior at all times during league events. Players, coaches and parents are expected to show a respectful attitude for everyone involved in the sport. Conduct which is detrimental to the sport by the participating club will not be tolerated. Such conduct may include, but is not limited to: Vulgarity by coaches, swimmers or parents; Harassment or belittling of officials, coaches or swimmers; Physical violence or the threat of physical violence toward anyone before, during or after a meet; verbal abuse directed toward anyone before, during or after a meet; The taunting of opposing swimmers, coaches and parents The conduct should be reported immediately to a coach and/or to an officer of the CCCCSL. The CCCCSL officers (President, Vice President and Meet Director) have the sole right to determine whether a violation has occurred, and to enforce any penalties deemed appropriate. Punishment may render a swimmer or coach unable to participate in or attend a dual meet event, either home or away, or may prohibit the offender from competing in the championship meet.