2023 Summer Camp Registration

The Arlen Specter US Squash Center 2023 Summer Camp Registration Form

Thank you for taking part in activities at the Specter Center - the world's largest community squash center and home of US Squash!
Participant's Full Name*

First NameLast Name
Participant's Date of Birth*

MonthDayYear
Date
Participant's Gender*

MaleFemaleNon-BinaryPrefer not to say
Participant's Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Participant's School*
Are there any medical conditions we should know about?*
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Emergency Contact: Full Name + Phone Number*
Do you know your US Squash Club Locker account number? (if you do not have an account please visit spectercenter.org/member login to create one.)
Please select the session you are registering for:

Week 3- June 26-29Week 4- July 10-13Week 5- July 17-20Week 7- July 31- August 3Week 8- August 7-10- ALL GIRLS WEEK!Week 9- August 14-17Week 10- August 21-24- College Squash Recruiting Prep WeekWeek 11- August 28-31
Week 1 (June 12 - 15)
Week 2 (June 20 - 22)
Week 3 (June 26 - 29)
Week 4 (July 10 - 13)
Week 5 (July 17 - 20)
Week 6 (July 24 - 27)
Week 7 (July 31 - August 3)
Week 8 (August 7 - 10) ALL GIRLS WEEK!
Week 9 (August 14 - 17)
Week 10 (August 21 - 24) College Squash Recruiting Prep Week
Week 11 (August 28 - 31)
Tot Squash-9:00-11:00 am- Please select the session you are registering for:

Week 1- June 12-15Week 2- June 20-22Week 3- June 26-29Week 4- July 10-13Week 5- July 17-20Week 6- July 24-27Week 7- July 31- August 3Week 9- August 14-17Week 11- August 28-31
Are you interested in receiving financial assistance on Specter Center Summer Camp?*
If you are interested in receiving assistance, please submit the following information:(1.)Most recent year’s 1040 Federal Tax Return (2.)Two most recent pay stubs for all adults in the household If you are unable to provide the required documentation please email membership@spectercenter.org

Cancelof
Are you interested in purchasing a Specter Center Membership?*

YesNoMaybeAlready have one!
A non-refundable deposit will be required for each selected camp week. You will automatically be charged $200 ($75 for Tot Squash) once the application is submitted, followed by a one-time charge for the deposit on remaining weeks. *
If you are unable to attend a camp week you must inform squashpro@spectercenter.org within one week or more of the start date in order to receive a refund less the deposit. If you cancel within one week of the start date, you are not entitled to a refund. *

Summer Camp DepositA non-refundable deposit is required to hold each selected camp week. This deposit will be applied to the camp week.

$200.00

Tot SquashA non-refundable deposit is required to hold each selected camp week. This deposit will be applied to the camp week.

$75.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. 
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The Arlen Specter US Squash Center 2023 Summer Camp Registration Form

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. 