Registration form - North Saint Johns Swim and Tennis Club
North St. John’s Swim and Tennis Club, Inc. Adult Swim Program Registration Form Mail Registration and payment to: Megan Mackey 2761 Weatherstone Drive Ellicott City, MD 21042 [email protected] Checks should be made payable to: North St. John's Swim and Tennis Club, Inc. Please Detach this Form and Return with your Payment The Adult Swim Program will meet 1 morning and 1 evening per week for 12 weeks. Days ____ 1 morning / 1 evening ____ Drop-In morning or evening Total Amount Enclosed: Fee Total $30 _____ $5 per session x # sessions _____ _____ _____ Name: Address: Please provide all information E-Mail Address: Phone Number (Home/Cell): Waiver, Release, Assumption of Risk: I hereby release, hold harmless, discharge and agree not to sue NSJ, its Club/Teams, Directors, Officers, Employees, Coaches, Officials, Volunteers, Agents, Sponsors, Advertisers, Owners/Lessors of Premises for all liability. Signature of NSJ Member Emergency Contact Phone Number
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