2020 Fall Men's & Mixed Tennis Registration Form
The City of Bloomington does not discriminate on the basis of disability in the admission or access to, or treatment or employment in, its services, programs or activities. Upon request,
accommodation will be provided to allow individuals with disabilities to participate in all City of Bloomington services, programs and activities. Upon request, this information can be
provided in Braille, large print, audio tape and/or computer disk.
Cancellation/Withdrawal Policy
Full refunds will be processed if the league your team is registered for is cancelled by
Parks and Recreation due to lack of teams.
Pro-rated refunds will be processed if scheduled games are cancelled and make up dates
are not available due to unavailable facilities.
Teams will receive a full refund less a $50 service charge if your team withdraws at least 3
weeks before the start of play.
Refunds will not be processed if your team withdraws less than 3 weeks before the start of
play or if your team is removed from the league due to disciplinary action.
Card Number __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __
Authorized Fee Amount: $____________
Payment Method:
Cash Check # _____ (Payable to City of Bloomington)
Visa MasterCard Discover AmEx
Cardholder Name: _______________________________
Cardholder Signature:_____________________________
Expiration Date: ____ / _______ CVV ______
(3 Digits on Back, AmEx: 4 on front)
For Office Use Only
Date Received____/____/_____ Staff Initials: ______
Partner’s Information ___ I need a partner
Partners Name: _____________________________
Team Name: _____________________________
Player Information
Name: ____________________________________
Address: __________________________________
City & Zip: _________________________________
Phone: (H) _________________________________
(W) _________________ (C) __________________
Email: ____________________________________
___ New Member ___ Returning Member
NTRP Rating:_________ (Ratings will be verified)
Substitute:___
____ Men’s Intermediate Doubles League *(Combined NTRP rating of team may not exceed 7.5)
Mondays, 6:30&8:00p.m. at Dred Scott and Valley View Courts $114.00/team
____ Mixed Doubles League *(One male and one female per team, no rating requirements)
Tuesdays, 6:30&8:00p.m. at Dred Scott Courts $114.00/team
Waiver
Release Agreement
Data Privacy Act/Tennessen Warning
SIGNATURE DATE
Both players on a doubles team must submit their
own signed registration sheet for the team to be
registered for a league, regardless of whether team
members are paying individually or having one player
submit payment for both players. If you would like to
register as a substitute for a league (no fee required),
please check on the substitute line.
C
ompleted registration form and full payment can
be returned via Fax: 952-563-8715 |
Email: parksrec@bloomingtonmn.gov
Mail/Drop-Off 1800 W Old Shakopee Road Bloom-
ington, MN 55431 ATTN: Tennis League
Checks payable to: City of Bloomington