USTA Missouri Valley Adaptive Tennis Program Registration

The USTA Missouri Valley would like to provide its resources to connect athletes to the Adaptive Tennis programs available to meet their tennis needs.

Please take a moment to complete this short survey.
 
1.

Program Contact Information:

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

2.

If your program has a web page, please enter below:
 

50 characters left.
3.

What type of tennis players does your program serve? (Please check all that apply)
Physically Disabled
Autism
Down Syndrome
Special Olympics
Developmentally Disabled
Athletes with Prostheses
Muscular Dystrophy
Hearing Impaired
Stroke
Athletes with Psychiatric or Emotional Needs
At-risk/Environmental-
ly Challenged
Multiple Sclerosis
Brain Injury/Disorder
Recreational Wheelchair
High Performance Wheelchair
Other  
4.

Approximate number of tennis players in your program.
 

50 characters left.
5.

Please indicate which USTA District where your program is held, please check all that apply. (If you are not certain, please indicate below)
Heart of America
Iowa
Kansas
Missouri
Nebraska
Oklahoma
St. Louis
I am not certain
  • Comment:

  • 500 characters left.
6.

This program is for
Adults
Juniors
Both
7.

Permission to post your program information on the USTA Missouri Valley Section web site? (missourivalley.usta.com)
Yes
No
8.

Are you interested in receiving information in regards to posting your program on the USTA (national) web site as well? (usta.com)
Yes
No

Thank you for your time. If you selected "Yes" in #7 above you will be receiving another e-mail from the USTA Missouri Valley Section with a link to the web page where your program is listed.