Registration

If you have questions please contact:

Keith Roland: 518-434-8112 (office) or 518-439-3247 (home)
Jason Ward: 518-857-8468 (mobile)

Please fill out one form for each child you are registering.
Child’s Name:
Child’s Age:
Sponsored: Yes    No

Register for Sailing
Child’s Ability Level:
Program Dates: Entire Season
Week 1 June 30 – July 3
Week 2 July 8–11
Week 3 July 15–18
Week 4 July 22–25		  
Week 5 July 29 – Aug 1
Week 6 Aug 5–8
Week 7 Aug 12–15
Week 8 Aug 19–22

Register for Swimming

Child’s Ability Level:
Program Dates: Entire Season
Week 1 June 30 – July 3
Week 2 July 8–11
Week 3 July 15–18
Week 4 July 22–25		  
Week 5 July 29 – Aug 1
Week 6 Aug 5–8
Week 7 Aug 12–15
Week 8 Aug 19–22

Register for Tennis
Child’s Ability Level:
Program Dates: Entire Season
Week 1 June 30 – July 3
Week 2 July 8–11
Week 3 July 15–18
Week 4 July 22–25		  
Week 5 July 29 – Aug 1
Week 6 Aug 5–8
Week 7 Aug 12–15
Week 8 Aug 19–22
Member’s Name:
Member’s Email Address:
Address:
City:
State:
Zip:
Phone:
Member Number:

Health and Medical Forms

Preliminary registration is welcomed with the above information, but registration is not complete until a Health Form and a Medical Authorization Form are both submitted and on file with Club staff. These forms will be mailed with the 2008 Summer Sports brochure, or you can obtain blank forms at the Club. And, it will be of great help and speed up a child’s first day if the information for the forms is completed and submitted with the above registration. Thank you..

Information for Junior Program Health Form and Authorization for Medical Treatment of Minors
Name of Minor:
Birth Date:
Known Allergies:
Special Conditions:
Date of Last Tetanus Shot:
Medications Now Being Taken:
Hospitalization Coverage for Above Minor:
Insurance Company:
ID or Contract Number:
Group and/or Person Named on Policy:
Pediatrician / Family Physician:
Name:
Address:
Telephone:
Name of Parent or Designated Guardian:
(Person who is on Club property while the child is on Club grounds)
Emergency Contacts:
Name(s):
Telephone(s):
Date providing the above information: