Edgebrook Swim and Tennis Club
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Summer family membership
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Primary Member's Name
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Last
Secondary Member's Name
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First
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Primary Member (Choose One)
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Secondary Member (Choose One)
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Primary Member's Full Birthdate
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Secondary Member's Full Birthdate
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Primary Member's Email
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Secondary Member's Email
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Primary Member's Home Phone
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Secondary Member's Home Phone
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Primary Member's Cell Phone
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USTA Rating
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2.5
3.0
3.5
4.0
4.5
5.0
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Secondary Member's Cell Phone
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USTA Rating
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2.5
3.0
3.5
4.0
4.5
5.0
N/A
Address
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Child #1 Name
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Last
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Child #1 Full Birthdate
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Child #1
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Child #2 Name
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Child #2 Full Birthdate
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Child #2
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Child #3 Name
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Child #3 Full Birthdate
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Child #3
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Child #4 Name
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Last
Additional Children's Information if Needed
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Please Attach a Photo Copy of (1) Adult ID
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Child #4 Full Birthdate
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