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Junior Holiday Program Online Form
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GTACWT
1. Camper's Information
*
Birth Date
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
*
Name
2. Session Information
Please specify which session you would like to register for below:
Session 1
Session 2
June 20-24
Session 3
June 27-July 1
Session 4
July 11-15
Session 5
July 18-22
Session 6
July 25-29
Session 7
August 1-5
3. Are You Interested in Registering for Half Camp or Full Camp?
Please make a selection below. If you are signing up for Full Camp, please skip the next question.
Half Camp
Full Camp
4. Days Attending (Half Camp Registrants Only):
Please select which days your camper will be attending.
Monday
Tuesday
Wednesday
Thursday
Friday
5. Parent Information
Preferred Title:
Select A Title
Mr.
Mrs.
Ms.
Miss
Dr.
Rev.
*
First Name:
Middle Initial:
*
Last Name:
*
Email Address:
Home Phone Number:
Work Phone Number:
Best Time To Contact:
Emergency Contact:
Relationship:
6. Bill Member Account?
Please enter your member number to process these charges at the same time as your membership dues.
Member #
7. Pay with a Credit Card, (MC, Visa, AMEX)
Please provide your credit card information and we will send a receipt once the transaction has been processed.
Card Number
Ex. Date
6. Medical Conditions.
Please list any food allergies or medical conditions your child may have in the space below.
Galleria Tennis & Athletic Club
5015 Westheimer, Suite 4020
Houston, Texas 77056
p | (832) 325-5100
e |
membership@thegtac.com
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