Main Applicant:	First Name:*
Previous NBTC members Ineligible for Groupon	Last Name:*
	E-mail address:*
	Cell Phone:*	If no Cell Phone, enter Home Phone
	Home Phone:
	Street Address:*
	City:*
	State:*
	ZIP Code:*
Spouse/ Significant Other:	First Name:
	Last Name:
	E-mail address:
	Cell Phone:
	Dependent First Names:	Dependents must be under the age of 18yrs And reside in the same household as parents
Groupon Number:*		(Number located below bar-code on Groupon certificate, eg: 1234-5678)
Select Trial Membership TYPE*	Trial Casual:	Members arrange their own tennis play, reserve courts No Tennis ‘Rating’ required Excludes: Club match arranging Includes: Full use of all Club facilities (pool, gym, social)
	Trial Competitive:	Member requires tennis 'Rating' (Club will arrange rating with Pro) Includes: Club match arranging (by Court-Directors) Includes: Invitation to all social tennis events Includes: Full use of all facilities (pool, gym, social)
Requested Start-Date:*		Nominate when you wish your two month Trial Membership to commence.

* Required fields

Terms:

In applying for membership, the applicant addresses that tenure of membership and the right of all persons entitled to use, through applicant’s membership, any facilities of the Club, shall be governed by the Rules and Regulations of the Club adopted and as the same may be hereafter amended; the applicant further states that this application is made with a complete understanding of the following conditions, privileges and restrictions governing the membership for which application is made:

Candidates for membership are subject to acceptance by the NBTC. The Club reserves the right to reject any application for membership.

Membership shall not confer upon any member any right, ownership, or interest in any of the assets or property of the Club.

Applicants for membership of NBTC acknowledge and accept that a camera security system is in effect throughout all general access areas of the Club and parking lot.

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I (Applicant, under-signed), on behalf of myself, my family members, guests and successors hereby agree to indemnify and hold harmless the Newport Beach Tennis Club, its officers, partners, directors, agents, and employees from and against any and all claims, actions, liabilities, damages of any Club facilities or participation in any Club sponsored events on or in connection with property owned or maintained by the NBTC.

I hereby consent that myself and family members may receive medical treatment by any paramedics, ambulance services, physician or hospital selected by the NBTC in connection with any personal injury or medical condition requiring treatment occurring during the use of any Club facilities or in participation of any Club sponsored events or the use of property owed or maintained by the NBTC.

I understand that I may resign my Trial membership at any time provided any indebtedness to the Club is paid in full prior to resignation.

I do hereby authorize the NBTC to verify the information contained herein stated, and do further request that all information be treated in a confidential manner.

I hereby agree to comply with all the rules and regulations of the NBTC. The rights, duties and obligations of all club members are governed by the provisions of the NBTC Rules and Regulations as outlined in the policies of which I have received a copy.

By submitting this application, I acknowledge that I have read, agree to, and understand all of the information contained herein.