2021 Summer Youth Programs Registration & Emergency Contact Form Name of Child* Member Number* Child's Birth Date* Age of Child* 5-7 8-10 11+ Gender*MaleFemaleGuardian Name* Guardian Phone Number*Guardian Email* Name and Number of Emergency Contact* Name of person to be notified in an emergency if parents are not available Relationship to Child* Medical and Conditions and/or Allergies Name(s) of any person(s) other than parents/guardians to whom the child may be released Address* Activity* Swim Team ages 5-7 & 8-10 FULL | June 8 – July 22) Junior Tennis Cost: $100/session or $25/day Junior Golf Cost: $100/session or $25/day Sessions (TENNIS ONLY) $100 per session Session 1: June 7- June 18 Session 2: June 21 - July 2 Session 3: July 5 - July 16 Session 4: July 19 - July 30 Sessions (GOLF ONLY) $100 per session Session 1: June 7- June 18 Session 2: June 21 - July 2 Session 3: July 5 - July 16 Session 4: July 19 - July 30 Sessions (SWIM ONLY) $160 Swim Only: All Summer Ages 5-7 & 8-10 FULL Member Charge Amount $* Member Signature* HiddenAge of Child*5-78-1011+HiddenActivityHiddenTennis and/or Golf sessions (NOT FOR SWIM)Session 1: June 7 - June 18Session 2: June 21 - July 2Session 3: July 5 - July 16Session 4: July 19 - July 30This regards Golf & Tennis. Swim is all summer long!
