Valley Center Tennis Camp Registration Form

Adam’s Park Tennis Courts

28751 Cole Grade Road

$159 for the week for ages 5 to 18!

When: June 20th to June 24th/Monday-Friday /9:00AM to 3:00PM

Includes: Tennis instruction by professional tennis teachers and top VCHS players! Instruction is geared to the
age and ability of each camper. Also included in the camp experiences: Swimming, lawn games, tournament play
awards, and even a Friday barbeque!

Bring: Tennis Racquet (See Chip Cullison should you need to buy one), swim suit, towel, sunscreen, sunglasses.
Sack lunch (Monday-Thursday).

Enrollment Process

Fill out the registration form below and take it, as well as payment, to the Valley Center High School athletic
department. (Checks just made out to VCHS). Please enroll by June 10th.

Name: _________________ Age: Address: ___ /

City: ___ Zip: Home Phone: ( ) _________ Cell: ( ) _______/

Parents or Guardian: ___________________ Day Phone: ( ) /

Physician: ________________________Phone: ( )________________________/
Insurance Co: _________Policy:____________________________________/
Policy Holder: ___________Medical Info: /
Emergency Contacts(Other than parent or guardian): ___________/
Phones: ( ) ___________________________________________________________/

Tennis Experience: [ ]Little or no Tennis Experience [ ]Beginner [ ]Intermediate [ ]Advanced

All campers receive a free VC Tennis Camp T-shirt! [ ]Child Adult sizes: [ ]SM [ ]Med [ ]Lg [ ]XL

I hereby register my child in the Valley Center Tennis Camp. I know of no health problems that may affect
participation in the camp. I authorize camp staff to act for me in any emergency requiring medical attention. I
hereby release and hold harmless the Valley Center-Pauma Unified School District and employees from any and
all liability that may arise out of my child’s participation in Valley Center Tennis Camp. I acknowledge
responsibility for all medical expenses due to my child’s illness or injury.

Parent or Guardian signature: _________________ Date: /

Contact us at: valleycentertenniscamp.com

VCHS Athletic Office: (760)751-5554

Director Chip Cullison: (858)254-7908
Asst. Director Bill Stribley: (760)749-8958