WEDS. NIGHT JR. CLINICS • SUMMER 2026

WEDNESDAY JR. CLINICS • SUMMER 2026 REGISTRATION

Hamptons Community Tennis Academy • 72 Ponquogue Avenue, Hampton Bays, NY 11946
IF YOU ARE EXPERIENCING ERRORS WHILE SUBMITTING THIS FORM,

PLEASE TEXT/CALL (631) 856-1880 OR EMAIL JORDAN@HAMPTONSCTA.COM
Wednesday Night Junior Clinics

Weds. July 8 - Weds. August 26

6:00 PM – 7:45 PM

Ages 6–17

Players grouped by age and ability.

Sessions consist of a dynamic warm-up, skill-building games, drilling, and situational match-play formats for advanced groups.

Weekly clinic spots are limited and filled on a first-come, first-served basis. Dates will be removed from the form if full.
Local Rate*:

1–3 Clinics: $48/clinic • 4–7 Clinics: $44/clinic

Non-local Rate:

1–3 Clinics: $52/clinic • 4–7 Clinics: $48/clinic

*Local Rate is reserved for students of Suffolk County schools
Athlete Information
Athlete Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Tennis Skill Level
Tennis ball type that player uses?
Describe the athlete's experience with tennis so far - years played, enjoyment, competition, etc. If no experience, simply write 'None'.
Registration
Student of a Suffolk County School?
School Name
Please note: Suffolk student discount is based on enrollment in a Suffolk County school, not residential address. Verification (report card or similar) may be requested. Questions: jordan@hamptonscta.com
Select Number of Sessions
1–3 Clinics: $48/clinic • 4–7 Clinics: $44/clinic
Select Number of Sessions
1–3 Clinics: $52/clinic • 4–7 Clinics: $48/clinic
Calculation
Select Session Dates (Must Reflect Selection Above)
8-Clinic Package Sibling Discount: Is Another Sibling Registered?
Receive a $10 discount if a sibling is also enrolled in an 8-Clinic Package
Name of Sibling
Parent/Guardian Information
Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about HCTA? If you were referred, please include the referrer’s name.
Final $ (calculation)
Discounted $ (calculation)
2.0 Final $ (calculation)
Emergency Information
Emergency Contact Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
The athlete may (select all that apply):
Name of Addtl. Authorized Pick-Up Individual

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Confirmation

By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
Date

MonthDayYear
Date
Signature
Total

prevnext( X )
USD

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

WEDNESDAY JR. CLINICS • SUMMER 2026 REGISTRATION

Athlete Information

Registration

Parent/Guardian Information

Total

Payment Methods