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1 REGISTRATION FORM

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Page 1: 1 REGISTRATION FORM. 2 Name: ………………………. First Name: …………………… Date of birth:…………………….. Address: …………………………………………………………………………………………...………

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REGISTRATION FORM

Page 2: 1 REGISTRATION FORM. 2 Name: ………………………. First Name: …………………… Date of birth:…………………….. Address: …………………………………………………………………………………………...………

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Name: ………………………. First Name: …………………… Date of birth:

……………………..

Address: …………………………………………………………………………………………...

……….

……………………………………………………………………………………………………………..

.

Zip Code: ………………. City: ………………………. Country: ……………………………….

Phone (home): ……………………………………......... Mobile phone:

………………………….

E-mail: ………………………………………………….

Passport no.: ……………………………….....................

Name: ………………………. First Name: …………………… Date of birth:

……………………….

Address:

………………………………………………………………………............................................

……………………………………………………………………………………………………………..

.

Zip Code: ……………... City: ………………… Country:

………………………………...

Phone (home): ………………………………………… Mobile phone:

……………………………

E-mail: …………………………………………………

TENNIS BACKGROUND

TRAINEE'S GENERAL INFORMATION

1. Ranking ITF/ETA:

……………………………………………………………………………………

2. Ranking ATP/WTA: …………………………………………………………………………............

3. National Ranking (specify country): ……………………………………………………………….

4. Number of weekly hours of tennis played in the last 6 months:

……………...........................

5. Number of weekly hours of physical training in the last 6 months:

……..................................

6. License number (French):

…………………………………………………………………………..

PARENTAL CONTACT/GUARDIANS

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

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ALL INCLUSIVE

TRAINEE: …………………………………………………………………………………………………

FROM ………………………… TO …………………………..

THIS PRICE INCLUDES:

• Full board accommodation

• Training sessions morning and afternoon

• Fitness sessions

• Issue of a French license (if required)

• Organization, accompaniments to tournaments

• Registration fees to tournaments

• Coaching during tournaments: matches briefing/debriefing

• Supervision by professional teachers 24 hours a day

• Delivery of a personalized training report with full review

• Extra-tennis playing activities

THIS PRICE DOES NOT INCLUDE:

• Transport to the site (possibility of pick-up at Marseille Airport or TGV train station at Aix-en-Provence for

€50 per person)

• Pocket money

• Extra-tennis playing activities to which trainees could participate (karting, tree climbing, movie, etc.)

• Stringing, tennis accessories

• Medical expenses

• Extra day price: €140

TOTAL PRICE: €

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

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4

METHOD OF PAYMENT

• REGISTRATION: In order to confirm your booking, a deposit of 50% of the total amount must be paid

within 7 days. Thank you for returning the contract with the deposit or a copy of the transfer. Registration will

only be considered after receipt of the contract and the first installment. Full payment must be paid before

the traineeship starts.

Note: For payment or transfer sent under a different trainee's name, please specify it here:

……………………………………………………………………………………………………………………...

CASH SETTLEMENT: Cash

WIRE TRANSFER:

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

Page 5: 1 REGISTRATION FORM. 2 Name: ………………………. First Name: …………………… Date of birth:…………………….. Address: …………………………………………………………………………………………...………

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UNDERTAKING

I, the undersigned, ………………………………….., acting as the parent of the enrolled child, certify having

read the registration and participation terms and conditions of the traineeship Provence Tennis Camp.

I hereby declare to accept the conditions mentioned in this document.

At: ……………………… date: ……………………….…

Signature

• Copy of ID Card and/or passport

• Copy of wire transfer

• Medical certificate certifying the trainee's fitness for playing tennis in tournaments. (If you have none, you'll find a copy to be completed by your doctor at the end of the registration file)

• Copy of the social security certificate and complementary health cover

• Copy of license for players playing in France

• Terms and conditions of the traineeship, initialed and signed by the trainee and his/her parents or guardians

• Parental authorization signed by the parents or guardians. (If you have none, you'll find a copy at the end of the registration file)

MANDATORY DOCUMENTS

IMAGE RIGHTS

Authorize the release of photographs taken during the PTC activities of my son/daughter on PTC's website, posters,

programs, information leaflets. (Please tick a box):

YES NO

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

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TERMS AND CONDITIONS/INTERNAL RULES

Page 7: 1 REGISTRATION FORM. 2 Name: ………………………. First Name: …………………… Date of birth:…………………….. Address: …………………………………………………………………………………………...………

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TERMS AND CONDITIONS OF ALL-INCLUSIVEPROVENCE TENNIS CAMP TRAINEESHIPS

1. SUBJECT MATTER OF THE CONTRACT

Provence Tennis Camp, through "Arnaud Agniel Tennis Camp", organizes tennis traineeships with accommodation aimed at players according to their ranking, already playing tennis and wishing to improve through participation and accompaniments to tournaments.

After having acknowledged the traineeship program, the fullboard accommodation and the conditions of accompaniments to tournaments, the parent(s) or guardian(s) in agreement with the child decided to entrust him/her to Provence Tennis Camp for a traineeship which dates, particulars and price are laid down in the "Individual Registration Form".

2. INTERNAL RULES/DISCIPLINE

Prior to signing the contract, the trainee and his/her parents or guardians declare having been informed and obtained all desired explanations on the mandatory rules about security, hygiene, conduct and behavior inherent to group living outside their usual residence that Provence Tennis Camp intends to enforce. The trainee expressly declares to adhere to them without limitation or qualification and undertakes to respect these rules throughout the traineeship.

3. CANCELLATION

As stated in Article 4.2 below, in case of cancellation of the traineeship at the request of the trainee and/or his/her parents or guardians within 45 days and up to 15 days before its start as indicated in the registration file, a cancellation penalty of 50% of the total price of the traineeship will be vested in Provence Tennis Camp which will expressly remain authorized to retain the sums paid at the time of booking the traineeship.

In case of cancellation of the traineeship at the request of the trainee and/or his/her parents or guardians within 15 days before its start as indicated in the registration file, the total price of the traineeship will be due and vested in Provence Tennis Camp.

Any shortened or abandoned stay, voluntarily or involuntarily (due to injury for instance), will result in the collection of a cancellation fee of 100% of the total price. In no way may the trainee claim reimbursement of part or all of the traineeship price.

4. PRICE/METHOD OF PAYMENT

4.1 – The price stated in the registration file is fixed and distinctive and includes on the one hand all sports performances (playing tennis, physical preparation, mental preparation, evaluation) and on the other accommodation services and catering at the Domaine de Valbrillant.

It does not include the cost of return transportation to the site which remains exclusively in the hands of the trainee and his/her parents or guardians.

The attention of the trainee and his/her parents or guardians is expressly drawn to the fact that accommodation and catering services are purely ancillary and basic, the main and decisive reason for the coming of the trainee being related to his/her will to improve tennis playing and benefit in this regard from the expertise and experience of Provence Tennis Camp.

4.2 – Method of payment: Paiement of 50% of the total price of the traineeship at the time of registration, i.e. signing the registration file. Paiement of the balance, i.e. 50%, before the commencement of the traineeship. Provence Tennis Camp reserves the right to refuse any trainee for whom the price of the traineeship would not have been paid in full on the first day.

5. TEMPORARY/PERMANENT EXCLUSION

Provence Tennis Camp reserves the right to exclude without notice, temporarily or permanently, any trainee whose attitude, behavior or appearance would be inconsistent with good morality or likely to affect the safety of persons or property, or notoriously embarrassing for others, or infringing the contract or the internal rules, or in the event of fraud or false statement. In such cases, the parents or guardians will be informed of shortcomings and problems identified and, in case of permanent exclusion, requested to fetch the trainee. An excluded trainee can claim no refund of any amount he would have paid.

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

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6. RESERVATIONS

During the traineeship, Provence Tennis Camp will not be held responsible in case of bad weather or any event of force majeure (tournament delay, accident, strike, lost luggage, etc.).

7. THEFT/LOSS OF VALUABLES

During his/her traineeship, the trainee is invited not to abandon or leave valuables unattended. Provence Tennis Camp accepts no responsibility and will not be held responsible for any theft related to clothing, footwear, personal textiles, mobile phones, music players, camera, jewelry and other valuables belonging to the trainee. The trainee acknowledges having been fully informed of the risks involved in bringing and keeping on site valuables during the traineeship.

8. MEDICAL CERTIFICATE

In accordance with and under the responsibility of his/her parents or guardians, the trainee declares to be in such physical constitution and health condition enabling him/her to generally practice sports, especially tennis, take part in the traineeship which program is known. On arrival at the site, at the beginning of the traineeship, the trainee submits a medical certificate attesting his/her fitness to practice sport and any document to verify that his/her immunization schedule is up to date. Any trainee's parent must report health problems as well as treatment history that can prevent or frustrate assiduous practice of tennis in competition or cause inability to perform the offered programs by Provence Tennis Camp.

The acceptance of these conditions authorizes Provence Tennis Camp to take all necessary steps in case of hospitalization and surgery.

9. CIVIL LIABILITY/INSURANCE

Provence Tennis Camp has taken out a liability insurance. This policy is to insure PTC against the financial consequences of civil liability incurred for personal injury, material damage, consequential losses caused to third parties arising from operating tennis traineeships. PTC cannot be held responsible in case of accidents resulting from the clear disregard of safety instructions or the improper use of equipment or other facilities.

In addition, the trainee, his/her parents or guardians must subscribe an individual civil liability policy covering the trainee for any damage he/she might cause to third parties as a result of his/her own act during the traineeship. Moreover, PTC informs the trainee of the advantage to subscribe an individual insurance policy with the insurer of his/her choice covering personal injury to which his/her sports activity may expose him/her.

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

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TRAINING

• Physical and tennis training are held at the Tennis Club Négrelien in Châteauneuf-le-rouge, France.

Each trainee will receive a personalized and intensive training adapted to the objectives set. The daily overview (training sessions, matches, etc.) will be communicated the previous evening during the daily debriefing.

The players are requested to respect the schedule of their training sessions and be fitted out with the necessary equipment for their matches (towel, bottle of water, etc.)

Free time is important for recovery. It is further recommended to players, outside the training sessions, to avoid the practice of other physical activities and to favor rest. However, entertainment and other activities are organized.

A stringing service is available. PTC works with the pro shop SPORTEAM in Meyreuil, France.

RULES OF LIFE

Trainees and parents should respect the internal rules of traineeships organization of Provence Tennis Camp.

The lifestyle rules are important for any athlete:

Theft/Vandalism: Parents of minors who will carry out such intrigues will fully support the consequences of the acts committed by their child. Provence Tennis Camp reserves the right to take measures up to the expulsion of traineeships.

Violence: Any violent attitude or disrespect towards other trainees or the teaching team will result in sanctions including expulsion, the transport costs remaining to be borne by the trainee's family.

Drugs/Tobacco/Alcohol: The use, trafficking and distribution of drugs are not tolerable in traineeships. Similarly, the use of tobacco is strictly prohibited. Equally, the consumption of alcoholic beverages within the PTC's installations is strictly ruled out.

Disrespect of the regulations will lead to measures and sanctions, at parent's expense, up to the permanent expulsion of the traineeships organized by Provence Tennis Camp.

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

INTERNAL RULES OF PROVENCE TENNIS CAMP TRAINEESHIPS

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COMMUNICATION

The management team is constantly concerned by listening to children and parents:

For any question or problem concerning your stay (accommodation, catering, coaching, training, etc.), please inform Arnaud or any other person in charge.

A personalized traineeship report with full evaluation will be given at the end of the traineeship.

MEDICAL

In case of health problem or injury during the traineeship a doctor can be contacted day or night.

The risks of accident during the traineeships organized by Provence Tennis Camp are covered by the insurance policy.

CONTACTS

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

Arnaud Agniel DIRECTOR(+352) 661820123

Pascal SAGNOL COACH (+33) 662163722

Domaine de VALBRILLANT Accommodation centre (+33) 442584676

ACCOMMODATION

Trainees are hosted at the Domaine de Valbrillant in rooms of 4 to 6 people. We favor the grouping of children by age to keep the rhythm of life.

During the week, the rooms are regularly looked after by a housekeeper.

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I, the undersigned, …………………………………………………………………………………………………….

acting as a trainee, certify having obtained and read the internal rules of Provence Tennis Camp. In

accordance with it, I pledge to respect the conditions described in this document.

Date…………………………….

Trainee's signature and his/her parents (guardians)

preceded by the words "read and approved":

ACCEPTANCE OF INTERNAL RULES

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

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Date:

………………………………………………………………………………………………………………………

Player's Last Name – First Name:

…………………………………………………………………………………….

Date of birth:

…………………………………………………………………………………………………………..

Address:

…………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………..

.

I, the undersigned, ……………………………………………………………… acting as doctor of

………………………………………………………….., certify that the health condition of the above named

person presents no contraindications to intensive sport. This person is therefore able to participate in a

competition traineeship at Provence Tennis Camp.

Doctor's signature:

MEDICAL CERTIFICATE

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

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PARENTAL AUTHORIZATION

Arnaud AGNIEL Tennis CAMPCOMPANY REGISTRY: A 39327

1, an DitertL-8076 BertrangeLUXEMBOURG

Phone: (+352) 661 820123www.provencetenniscamp.com

I, the undersigned, …………………………………………………………………………………………...

In his capacity as ……………………..……………………………………………………………………...

Responsible for the child …………………......................…………………………………………………...

Authorizes the Director of Provence Tennis Camp: Arnaud AGNIEL to coach our son (daughter) during

the tennis camps from …………………………. to …………………………

This authorization includes daily commuting and travel for the training sessions and matches during

tournaments in the region of Aix-en-Provence, France. This authorization also applies to the staff working

for Provence Tennis Camp for the period of the tennis traineeships.

Read and approvedDone at ……………………. on …………….. 2015