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.
____ 1 morning / 1 evening
____ Drop-In morning or evening
Total Amount Enclosed:
$5 per session x
# sessions _____
Please provide all
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