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Jimmie ‘Doc’ Horne
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CONTACT US
HOME
Schedule of Events
Clinic Schedules
Gaines Park Groundbreaking Ceremony
PROGRAMS
GPTA Clinic Programs
Training Resources
Baselines & Books
Register
Youth Registration
Adult Registration
PARTNERS
ABOUT US
Board of Directors
Jimmie ‘Doc’ Horne
Celebrating Black History Month
Ways to Get Involved
Donate
Volunteer
CONTACT US
ADULT REGISTRATION FORM
First Name
Last Name
Preferred Name
Home Street Address
City
State
Zip code
Email
Date of Birth
Age
Primary #
Which type is Primary # ?
Mobile
Home
Alternate #
Gender
Female
Male
Prefer Not To Say
EMERGENCY CONTACT
EMERGENCY TELEPHONE #
Do you have any special needs?
Yes
No
If Yes, please explain:
Do you take medication(s)?
Yes
No
If Yes, please list medication(s)
Do you have any allergies?
Yes
No
If Yes, please list allergies
Select which session you are registering for.
2025 Session 1 ((January 13 - March 8)
2025 Session 2 (March 24 - May 17)
2025 Session 3 (June 2 - July 26)
2025 Session 4 (August 11 - October 4)
2025 Session 5 (October 20 - December 13)
Select which clinic(s) you are registering for.
Beginners
Drills & Skills
Women's Fit
Select which clinic day(s) you will be attending.
Beginners Monday 5:50PM - 6:50PM
Beginners Saturday 9:00AM - 10:00AM
Women's Fit Wednesday 5:50PM - 6:50PM
Drills & Skills Saturday 9:00AM - 11:00AM
Select which clinic day(s) you will be attending.
Beginners Monday 5:50PM - 6:50PM
Beginners Saturday 9:00AM - 10:00AM
Women's Fit Wednesday 5:50PM - 6:50PM
Drills & Skills Saturday 9:00AM - 11:00AM
Course Fee
I also understand and accept that there is a $25 fee per Eight (8) week session.
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In consideration of being permitted to participate in clinics, lessons, leagues and programs, I hereby release, waive, and discharge the City of West Palm Beach, its agents, employees, volunteers, and Gaines Park Tennis Association from all liability for all injury, loss or damage, and any claim of damage to my person or property during my participation. It is understood that I may be photographed while at the Tennis Center and the photographs may be used in official City of West Palm Beach publications was well as official publications by Gaines Park Tennis Association. It is further understood that any false information provided for in this registration form will be cause for immediate termination based on participation safety and ratios.
Signature
Date
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