Tennis lessons – Application 2015/2016

TENNIS CLUB GASPERICH a.s.b.l.
affilié à la FLT depuis 1984
Adresse postale : B.P. 1684
L-1016 Luxembourg
E-mail : [email protected]
Terrains : rue Jacques Stas, L-2549 Gasperich
Web : www.tennis-gasperich.lu
Tél. Secrétariat : (+352) 621 152 992 / (+352) 621 242 710
BCEE : BCEELULL IBAN LU78 0019 1100 2864 6000
CCPL: CCPLLULL IBAN LU94 1111 0882 6087 0000
ING :
BIL :
CELLLULL IBAN LU79 0141 4200 4870 0000
BILLLULL IBAN LU55 0022 1312 3010 0000
Tennis lessons – Application 2015/2016
 new inscription
 re-inscription
Name : ____________________________________ First name : _________________ Gender : _______
Address (N°, street): ____________________________________________________________________
L- __ __ __ __ ________________________________________ Date of birth : ____ /____ /_________
Tel. : ______________________ GSM : _______________________Tel. office : ____________________
E-Mail : ______________________________________________________________________________
 Level of play :
 Beginner
 Intermediate
 Training :  HOBBY Training
 Advanced
Ranking : _____________
 COMPETITION Training
 Number of weekly tennis lessons :
 1 hour
 2 hours
 3 hours
 4 hours
 5 hours
 6 hours
 Please check (X) all your availabilities in the table below :
Time
00
00
13 - 14
1400- 1500
1500- 1600
1600- 1700
1700- 1800
1800- 1900
1900- 2000
2000- 2100
Tennis (adults, teens and kids as of 7 years)
Monday
Tuesday Wednesday Thursday
Friday
physical training
Mini-Tennis
Saturday
00
00
9 - 10
1000- 1100
1100- 1200
1200- 1300
physical training
physical training
physical training
 Number of weekly physical training lessons :
 SUMMER subscription :
 Mini-Tennis
 Licence FLT :  Kids U10
 none
 1 hour
 Juniors U18
 Kids Competition
 Students U25
 Adults HOBBY
 Chèques-service accueil (for kids under 12 years) :  yes
 2 hours
 Adults
 Adults Competition
 no
By signing the registration form, the signatory declares to have read the registration terms and general conditions
of courses offered by the Tennis Club Gasperich and accepts to respect them.
Date : ____ /_____ /________
Signature_________________________
This application form has to be send to the secretary’s office of Tennis Club Gasperich before July 15th, 2015 :
Tennis Club Gasperich B.P. 1684 L-1016 Luxembourg or by e-mail : [email protected]
Entreprise de Toitures
Couverture & Ferblanterie
Jean GOERENS
Luxembourg-Gasperich
Tél. : 486347 Fax: 26296708