Program Registration AgreementProgram Registration Agreement • March 31st, 2022 • Arizona
In consideration of participation in the Activities (as defined below), I, the undersigned, for myself, my personal representatives, assigns, heirs, and next of kin, agrees to the following terms:
Program Registration Agreement and Terms & ConditionsProgram Registration Agreement • March 20th, 2015 • Utah
YMCA of Callaway County Program Registration AgreementProgram Registration Agreement • July 29th, 2020
The YMCA policy outlined within this document applies to all program registration. Other privileges and limitations of YMCA programs may be established but cannot conflict with the policies herein.
Channel Islands YMCAProgram Registration Agreement • February 10th, 2021
PRIMARY ADULT Legal First Name Middle Initial Legal Last Name Date of BirthMale Female Home Address City State ZIP Home Phone Cell Phone Cell CarrierCheck here to receive text messageupdates Emergency Contact Name (Required. Must be outside of household) Emergency Contact Phone Relationship
ContractProgram Registration Agreement • January 28th, 2009
ELIXR TEEN FIT PROGRAM REGISTRATION FORM The program set out in this agreement is between the student or parent/guardian if student is under the age of eighteen years (identified on the front of this agreement) and Elixr Health Clubs (Elixr) situated on the premises stated above. Elixr Health Clubs is the trading name of Elixr Easts Holdings P/L - ABN: 84 111 634 747 Student Name: First Name: Surname: Address: Street:Suburb: State: Postcode: Date of Birth: Age: Sex: Height(cm):Student Asthma Bronchitis Autism SPD Motor Sensory Disorder Epilepsy Medical ClearanceMedical History: Diabetes Heart Disease ADHD APD Behavioural Condition Other: Parent / First Name: Surname:Guardian :Details Contact Number: Email: Emergency: Contact Name: Contact Number: Member of Elixr: Yes No Member Tag Number: Member Full Name: PRE-EXERCISE QUESTIONNAIREThis section is to be completed by a parent/guardian who is responsible for the medical care of the young person. Does your child have, or previously had:
Program Registration Agreement and Terms & ConditionsProgram Registration Agreement • October 24th, 2016 • Utah
