Which location are you applying for?
Choose OneAkronArlington HeightsCincinnatiClearwaterColumbusDaytonFort WorthGrand RapidsLorain/ClevelandLouisvilleMurfreesboro/NashvilleNapervilleOrlando/Lake NonaOrlando/Red BugPittsburghSarasotaScrantonSouth BendWacoYoungstown
Date of Birth (month/day/year)
Age of Athlete
Medical condition(s) that Buddy Up should be aware of:
Please list your athlete’s favorite hobbies (games, characters, movies, foods, music):
What motivates your athlete? What is your reward method? (Praise or something tangible, please explain)
Does your athlete have trouble transitioning from one activity to the next? Explain your technique used at home and/or school:
Does your athlete respond better to a male or female? Adult or peer of same age?
Does your Athlete currently participate in special needs based activities?
If so, which ones?
Does your Athlete participate in any typical based activities outside of school?
Is your Athlete potty trained?
Does your Athlete use/respond to sign language?
What are your goals for your Athlete at Buddy Up? Your athlete's goals?
As a parent of a Buddy Up Athlete, how would you like to get involved?
Fundraising: Help in the securing of funds, goods and/or services in support of Buddy UpRecruit Athletes and Buddies: Promote Buddy Up in the community and local schoolsActivities: Plan quarterly celebrations
Relationship to athlete
Buddy Up Tennis Fitness and Fun provides one shirt that should be worn to all clinics. Please indicate
your athlete’s shirt size
Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult XL
If you do not receive a reply within 5 business days, please contact Beth@buddyuptennis.com.
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