~Print This Page and Mail Along with Payment *MADE OUT TO*: HiersTennis, 1122 North Broadway, Stillwater, MN 55082 *Upon receipt, you will be emailed a confirmation. *If you need to cancel, please do so prior to the start of the activity to receive a refund. This applies to those taking private lessons as well. *For outdoor programs: you should wear a hat and sunscreen, and bring a towel and lots of water. ____________________________________________________________ ***REGISTRATION AND WAIVER FORM*** (Fill out only that which applies to the program in which you are registering.) Drill/Program Name:_________________________________________ Session/Dates:_____________________________________________ Days:__________________________ Times:_____________________ Level:__________________________ Age(Juniors only):________ Name of Participant:______________________________ Phone #:________________ Emergency contact #:_______________ Email address (required):______________________ Amount enclosed:$_________ Waiver of Liability: I hereby agree to specifically assume all risk of injury to me and/or dependents while participating in any Hiers Tennis programming, and I hereby wave any and all claims or actions I may have against Joele and Greg Hiers and/or his employees as a result of such injury. ________________________________________ Date__________ Signature of participant or guardian of