MAGIC EXPRESS TENNIS CLUB MEMBERSHIP APPLICATION
METC/PO Box 15686/Durham, NC 27704
www.magicexpress.20m.com

PERSONAL INFORMATION
Last Name: ______________________________, First Name: ____________________________

Address: ________________________________________________________________________

City: _________________________________, State: _______________, Zip: ________________

E-mail address (please print clearly): _________________________________________ (leave e-mail address blank if you don’t want e-mails with METC info sent to you)

TENNIS INFORMATION
NTRP rating—OR—If you don’t have an NTRP rating, please indicate if you are a beginner, intermediate or advanced player.  _____________________

PHONE NUMBERS
Unless you indicate otherwise, the numbers you provide below will be used for our club directory, which will be published in our newsletters.  Club members to contact you use the directory.  Please indicate on this form if you do not want a number(s) published as a part of the membership directory.

Home # _________________________, Work # _______________________, Pager/cell # ____________________ I don’t want my number(s) published _____.

PLEASE CHECK MEMBERSHIP TYPES:  (additional information requested below.)
Individual ($30) ________, Family—adults and children ($45) __________, Junior—Ages 6-18 ($15) ___________

Would you be interested in (please circle all that apply):
Team Travel Matches	Working with the Junior Development program	Serving on a club committee Playing on a USTA League Team(s)	

FAMILY INFORMATION (only fill in this section if you have a family membership).  Please indicate the following on the blanks below: Name, NTRP rating/playing level, whether they are junior or adult and contact phone numbers/address if different from yours.

1) _________________________________________________________________
 
2) _________________________________________________________________

3) _________________________________________________________________ 

Guardian/Emergency Contact Information: (Guardian information needed for all junior memberships).  This information is needed so that it will be available in case of emergency.

Guardian/Emergency contacts name & number: _________________________________, ____________________,	


Complete address (if different from address provided for member)

RELEASE STATEMENT:
I (we) hereby release the Magic Express Tennis Club from any and all responsibilities for accidents or losses incurred as a result of participating in club activities.

Signature of Member _________________________________________________

Signature of parent (required for members 18 years and under) ____________________________________

Method of payment: Cash amount: ____________ Check amount: ___________ Check no. ________ 
Received by ____________________________ Date paid ______________