Registration | Tennis Success

Tennis Success at Tennis Success Community Courts and Center

For CCISD programs please contact your school office. Learn More

Before you begin, please read the following documents:

Code of Conduct

Policy and Procedures

After the documents have been read, you may proceed to registration:

If accepted into the program, please download, print, and return these documents to the Tennis Success Office.

Medical Release Form

Education Program

Registration Form

Please use the form below or download and print application. Return completed application to the Tennis Success office.

"*" indicates required fields

Step 1: Which program is your child being registered for?*

Tennis Success After School Program

Tennis Success Summer Camp

Tennis Success Academic Aces School Program

Step 2: Has your child participated in a Tennis Success program in the past 12 months?*

Yes

Do you need to update any student information?*

Address

School

T-Shirt Size

Shoe Size

Parent/Guardian Info

Medical Form

Does your child meet the federal guidelines for free or reduced lunch?*

Yes

We are sorry, your child does not qualify for the Tennis Success program.

Please consider registering your child in a tennis program closest to you at:
HEB Tennis Center -520 Shely St, (361) 882-6013
Corpus Christi Athletic Club - 2101 Airline Rd, (361) 992-7100 x 8
Corpus Christi Country Club - 6300 Everhart Rd, (361) 991-7561
Northshore Country Club - 801 Broadway Blvd, (361) 643-6057
Al Kruse Tennis Center - 502 King St, (361) 883-6942

Child Information

Child's Name*

First Last

Age*

Please enter a number from 5 to 21.

Date of Birth*

MM slash DD slash YYYY

Address*

Street Address Address Line 2 City State ZIP Code

Grade*

If registering your child for the summer program, what grade will your child be in for the upcoming school year?

School*

School Extra-Curricular Activities*

Gender*

Female

Male

Ethnicity*

Hispanic or Latino

Not Hispanic

Race*

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

T-Shirt Size*

Shoe Size*

Does Your Child have any siblings attending the program?*

Yes

Please provide the names of siblings attending the program*

Parent/Guardian Information

Legal Name*

First Last

Phone*

Email*

Relationship to the child*

Secondary Contact

Name

First Last

Phone

Relationship to the child

Additional Contacts

Please list any additional adults that you authorize to pick up your child.

List

Name

Phone Number

Relationship

Medical Form

Doctor's Name

First Last

Doctor's Address

Street Address Address Line 2 City State ZIP Code

Doctor's Phone

Insurance Information

My child has medical coverage under:

Employer Insurance

Private Insurance

Medicaid

Other

Name of Insurance Company

Name of Policy Holder

Policy #

Group #

Medicaid ID#

Issuer ID#

Date Card Sent

MM slash DD slash YYYY

Allergies and Medical Conditions

Does your child have any allergies (to food, plants, animals, insects, medicines, etc.)?*

Yes

If yes, please describe the allergy, the severity of the reaction, requested accommodations, and what is done to manage them.*

Does your child have any medical conditions, physical limitations, or psychological disorders that may affect his/her experience in our program?*

(depression, anger, ADD, ADHD, bipolar, etc.)

Yes

If yes, please list and describe the condition in detail.*

Medications (inhalers included)

Tennis Success at this time is NOT equipped to administer medication. Children that need to take medication must take it before arriving at the tennis courts. The only exception is for children that may need an inhaler from time to time. Children that need an inhaler must keep the inhaler in their possession at all times and be able to administer the medication on their own. In this instance, we ask that staff is made aware that an inhaler may be needed during the hours of the program.

Does your child have asthma?*

Yes

If yes, will your child need his/her inhaler during our program?*

Yes

Past Surgeries & Treatment

Identify all surgeries or similar procedure your child has received and dates. If yes, please describe the condition in detail to assist us in. providing the best program experience for your child.

Consent

Code of Conduct Consent*

I agree to the Code of Conduct.

Download and Read Code of Conduct

Policy and Procedures Consent*

I agree to the Tennis Success Policy and Procedures.

Download and Read Policy and Procedures

Activity Consent*

I agree

By checking this box, I give permission for my child, so named above, to participate in all activities including, but not limited to tutoring, tournaments, field trips, and excursions. I also grant permission for Tennis Success staff to arrange for transportation and transport my child to program activities including those for field trips.

Photos Consent*

Yes

By clicking yes, you give Tennis Success permission take and use any photographs or other media, without limitation or obligation, of your child to promote Tennis Success programs now or in the future.

Safe Experience*

I agree

By clicking "I agree", I recognize that Tennis Success will do its best to ensure a safe experience, I understand that accidents may occur both from my child's participation in program activities and from transportation to/from the program. I agree to assume these risks. By clicking above, I release Tennis Success and its authorized staff from all liability based on any damage, loss, or injury whether the result of ordinary negligence or otherwise, caused to my child or to me from participation in Tennis Success programs.

Tournaments Consent*

I agree

By clicking above, I understand that my child must attend all tournaments they have been entered into. In the event my child does not attend for an unexcused reason, I accept the responsibility of paying the tournament's entry fee.

Availability Consent*

I agree

By clicking above, you are stating that you understand that there are a limited amount of spots for the Tennis Success program. If there are no longer spots available your child will be put on a waiting list until a spot becomes available.

Signature*

By providing your name above you are stating, I have read and understand the above application and do hereby attest the information provided by me on this and other related program forms to be correct and completed to the best of my ability giving permission to Tennis Success to provide the services indicated.

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