Junior Program Winter Application

Junior Program WINTER APPLICATION

On-line APPLICATION for the Pass Academy Winter Junior Programs at PSTC (Step 1 of 2)

The following is a session application request form, no payment information is entered at this time with this form. After the form is submitted, the Pass Academy Office will contact the parent regarding the next step.

If the student is accepted into the requested session, the parent will be given a link to an on-line payment form to pay the session fee and secure the student in the session (Step 2).
If a different session or an evaluation is recommended, the parent will be contacted with additional information/scheduling before being given the on-line payment form.

We will notify you as soon as possible regarding placement for the winter and follow up with payment information if you are assigned a spot. We appreciate your cooperation in having your children evaluated.

Junior Program APPLICATION Form Winter 2022/23
All students NEW to Pass Academy, ages 7 and older, MUST SCHEDULE a free EVALUATION with our tennis staff PRIOR to a Fall/Winter/Spring application submission. Schedule an Evaluation Here
Additional options are available at Bullis School, passacademybullis.com.
Student's Name*
First Last
Age*
Please enter a number from 5 to 18.
Parent Information
Parent's Name*
First Last
Address*
Street Address City State ZIP Code
Parent's Email Address*
Enter Email Confirm Email
Home Phone*
Parents's Mobile Phone
Parent's Office Phone
Potomac Swim & Tennis Club Member*
- Yes
- No
Answers are verified & provide for member discounts.
Winter October 31st - April 9th
(Member Price/Non-member Price)
Additional options are available at Pass Academy at Bullis.
PA KIDS: Ages 12 & under. The focus is on player development, using a modified ball and specific techniques in learning the game of tennis.
PA KIDS ~ Winter 2022/23
There are no options available for this field.
All PAK classes all full.
BEGINNER / INTERMEDIATE: Ages 11-14. At the Beginner/Intermediate level, the program’s goals are to teach boys and girls basic tennis skills and strategies in a fun, encouraging and enthusiastic environment. Emphasis is placed on developing tennis skills, along with confidence and a positive attitude.
BEGINNER / INTERMEDIATE ~ Winter 2022/23
There are no options available for this field.
All BI classes are full.
DEVELOPING TOURNAMENT: Ages 9-14. This is an intensive program for Intermediate and Advanced boys and girls. The training is devoted to instructional sessions on court, physical conditioning to develop strength and speed, extensive drilling to sharpen all strokes, and competitive play.
DEVELOPING TOURNAMENT ~ Winter 2022/23
- Fri 5:30 - 7 ($860/$1060)
- Sat 12 - 1:30 ($860/$1060)
- Sun 12 - 1:30 ($860/$1060)
HIGH SCHOOL VARSITY: Ages 13-18. This program consists primarily of players who are currently on their High School Varsity team along with players who would like to improve their tennis skills.
HIGH SCHOOL ~ Winter 2022/23
There are no options available for this field.
All High School classes are full.
Medical Authorization & Release
Student Name*
First Last
Student Condition*
- By checking this box it is understood that the student is in overall good physical health. If your child has a physical condition that may limit or restrict participation in certain activities, a physician’s note granting permission to participate in such activities must be presented prior to the first class session.
Date of Medical Authorization*
MM slash DD slash YYYY

By dating above, in an emergency, when I/we cannot be contacted, I/we hereby authorize the staff of the Pass Academy to take my/our child to the emergency room of the nearest hospital. I/we authorize that hospital and its medical staff to provide treatment deemed necessary for the well-being of my/our child.
Date of Parent Release*
MM slash DD slash YYYY

By dating above, I agree to hold the Pass Academy and Potomac Swim & Tennis Club harmless for injury or loss that may occur as a result of my participation in Pass Academy activities.
Cancellation Policy*
- By checking this box I accept the following policy. Cancel prior to 1st class: pay for 1 class. Cancel after 1st class: pay for 1 class plus $75 replacement fee. Cancel after 2nd class: pay for 2 classes plus $100 replacement fee. Plus credit card fees. No refunds after 3rd week. Medical reasons will be accepted with a doctor’s note.
Permission for Photo Use*
- Yes
- No
I give permission for photos of my child participating in Pass Academy at Potomac Swim & Tennis Club programs to be taken and used for the Pass Academy Website and/or Facebook page. We understand that if students are identified, only their first names will be used.
Additional Information (optional)

Junior Program WINTER APPLICATION

On-line APPLICATION for the Pass Academy Winter Junior Programs at PSTC (Step 1 of 2)

Junior Program APPLICATION Form Winter 2022/23

Parent Information

Winter October 31st - April 9th

(Member Price/Non-member Price)

Additional options are available at Pass Academy at Bullis.

Medical Authorization & Release