Whitehouse Tennis lessons
Emergency / Registration Information

Child’s Name:_______________________________________________ Gender:   Boy   Girl     

Mother’s Name: ________________________________________ Cell #: ___________________

Father’s Name: _________________________________________ Cell #: ___________________

Emergency Contact: _____________________________________        #: ___________________

Known Allergies: ______________________________________________________________________________

Behavioral/Emotional/Physical Issues that might be helpful for us to know: ________________________________


You are welcome to stay and watch the lessons.
If you leave your child unattended, we will expect them to stay at the Tennis Facility under our supervision.

Our intent is to handle minor scrapes, bruises, sprains with our local first aid kit.
If something serious happens we will call 911, and then call you at the numbers listed above.

In an emergency, your child may be transported to the nearest hospital emergency room by 911 paramedics /EMS.
Your signature authorizes that transportation if deemed to be medically necessary by the responding 911 paramedics /EMS.

Does your child have special medications that should be administered
by 911 paramedics / EMS in the event of an emergency?   Yes   No

If yes, please explain: ______________________________________________________________________

Parent Signature: ____________________________________________________

Date: ___________________________
The above information will be used solely by TriSail Enterprises or Whitehouse ISD and be kept confidential.    
Modified 2017-01-10