2023-2024 RIRC Season Court Application

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Court Captain Information

Name - Court Captain*

First Name

Last Name

Address 1 - Court Captain*

Address 2 - Court Captain

City - Court Captain*

State - Court Captain*

Zip Code - Court Captain*

Phone - Court Captain*

(xxx) xxx-xxxx

Email Address - Court Captain*

Current RIRC Member - Court Captain*

Yes No

Player 1

Name - Player 1

First Name

Last Name

Address 1 - Player 1

Address 2 - Player 1

City - Player 1

State - Player 1

Zip Code - Player 1

Phone - Player 1

(xxx) xxx-xxxx

Email Address - Player 1

Current RIRC Member - Player 1

Yes No

Player 2

Name - Player 2

First Name

Last Name

Address 1 - Player 2

Address 2 - Player 2

City - Player 2

State - Player 2

Zip Code - Player 2

Phone - Player 2

(xxx) xxx-xxxx

Email Address - Player 2

Current RIRC Member - Player 2

Yes No

Player 3

Name - Player 3

First Name

Last Name

Address 1 - Player 3

Address 2 - Player 3

City - Player 3

State - Player 3

Zip Code - Player 3

Phone - Player 3

(xxx) xxx-xxxx

Email Address - Player 3

Current RIRC Member - Player 3

Yes No

Player 4

Name - Player 4

First Name

Last Name

Address 1 - Player 4

Address 2 - Player 4

City - Player 4

State - Player 4

Zip Code - Player 4

Phone - Player 4

(xxx) xxx-xxxx

Email Address - Player 4

Current RIRC Member - Player 4

Yes No

Player 5

Name - Player 5

First Name

Last Name

Address 1 - Player 5

Address 2 - Player 5

City - Player 5

State - Player 5

Zip Code - Player 5

Phone - Player 5

(xxx) xxx-xxxx

Email Address - Player 5

Current RIRC Member - Player 5

Yes No

Player 6

Name - Player 6

First Name

Last Name

Address 1 - Player 6

Address 2 - Player 6

City - Player 6

State - Player 6

Zip Code - Player 6

Phone - Player 6

(xxx) xxx-xxxx

Email Address - Player 6

Current RIRC Member - Player 6

Yes No

Player 7

Name - Player 7

First Name

Last Name

Address 1 - Player 7

Address 2 - Player 7

City - Player 7

State - Player 7

Zip Code - Player 7

Phone - Player 7

(xxx) xxx-xxxx

Email Address - Player 7

Current RIRC Member - Player 7

Yes No

Disclaimer

I agree to provide the Roosevelt Island Racquet Club with a valid credit card number and expiration date, along with authorization to charge this account to cover any outstanding charges for my group in accordance with the following payment schedule: 50% deposit with signed application with the balance due on September 1, 2023 unless alternate arrangements are made in advance.  Also, I understand that all deposits are non-refundable subject to New York State exceptions. RIRC will provide you with a total amount due which will reflect the total cost of the court taking into account member / non-member court rates.  Season court captain MUST provide RIRC with a list of all players in their group along with their share of the court for invoicing purposes by September 1, 2023.  If we do not receive it then the balance of the court fee will be charged directly to the court captain's credit card on file.

I understand and acknowledge the risk of injury is inherent when playing tennis or in any program involving physical activity. By playing tennis at the club or participating in any club program, I hereby waive and release any rights and claims for damages I may have against Roosevelt Island Racquet Club, HCK Recreation Inc., any Program Director, or any of the professionals, for any injuries sustained by the player. I also give my consent to medical treatment, emergency or otherwise, inclusive of necessary transportation in order to receive such treatment in the event of injury or any other illness.