Bocage Junior Program Non Member Registration Form
Monday through Thursdays 4-6pm
Non member fees $36 per class. Fees billed monthly on class attendance
Sign up for as few or as many days as you like.

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* 1. Student First Name

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* 2. Student Last Name

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* 3. Home address

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* 4. City

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* 5. Zip Code

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* 6. Date of Birth

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* 7. Age

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* 8. Mom Name

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* 9. Mom Phone

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* 10. Dad Name

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* 11. Dad Phone

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* 12. Email

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* 13. Days to attend

Monday

Tuesday

Wednesday

Thursday

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* 14. Students Goals

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* 15. Credit Card Information - Payment Authorization: Charges for the Junior Program will be billed to a guest account with a credit card for payment set up for the non member. Credit card payments are drafted on the 10th of each month.

Name on Card

Card Type

Card Number

Expiration Date

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* 16. By checking "yes" I give my permission for my child to participate in the Bocage Jr. Tennis Program and I hereby authorize The Bocage Racquet Club, Inc. to draft Jr. Tennis Program fees to the credit card listed above.