NJ CANNONS REGISTRATION FORM

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NJ CANNONS REGISTRATION FORM

Program Fee: $100 (Member/Non-Member)
In order to be on the Cannons participants needs to know at least 2 strokes.

If more training is needed you can register for AQUA-ADAPT: https://forms.office.com/r/f2fprcFwpT

Personal Information
Parent/Guardian Name*

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Name*

First NameLast Name
Student Date of Birth*

MonthDayYear
Date
Are you a JCC Member?*

YesNo
Will the student be escorted by someone else?*

YesNo
Escort Name*

First NameLast Name
Escort Phone Number*
Please enter a valid phone number.
Escort Email*
example@example.com

TERMS AND AGREEMENT
PaymentPayment for THE NJ CANNONS must be received within 7 days of registering for the class. If not paid within 7 days, you will be removed from the registration. If you need assistance, please contact the Aquatics Dept at aquaticsdept@jccmetrowest.org.*

I understand
Withdrawals and Refunds: Any refund will be first applied to monies owed to the J. Please read the following information carefully so that you understand the JCC MetroWest policies regarding registration, withdrawals, and requests for refunds. No refunds will be issued once the session begins. If you withdraw from a class due to medical issues, you must contact the director to be refunded. The JCC MetroWest reserves the right to cancel any activity due to insufficient enrollment. In such cases, a full refund will be given. The JCC MetroWest reserves the right to change staffing and class instructors as needed.*

I understand
Tardiness: We encourage you to be on time for your lessons. Swimming lessons will begin promptly at the scheduled time.*

I understand
Make Up Policy: Due to a very tight schedule, no makeup is available.*

I understand
Communications: You can contact Megan McInerney (aquaticsdept@jccmetrowest.org) and she will follow up within 48 hrs. If you need immediate assistance you can call, during business hours, our Reception Team (973-530-3406).*

I understand

Please review and check that you agree to the following
Assumption of Risk: I understand, agree, and acknowledge that there are risks inherent in sports activities conducted by JCC MetroWest Aquatics School, including but not limited to paralyzing injuries, brain injuries, and death. These activities may be of a hazardous nature and/or may include activities such as swimming, diving, a variety of strenuous exercise and physical activities. With the full understanding of the facts, I state that to the best of my knowledge, my son/daughter listed has no medical, physical, or emotional health conditions which would hinder or prevent his/her participation in JCC MetroWest Aquatics School programs.*

I understand
Release of Liability: As the legal parent or guardian, I release and hold harmless JCC MetroWest its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of JCC MetroWest Aquatics School, its owners and operators or in route to or from any of said premises.*

I understand
Medical Emergencies: I grant permission for myself (or in case of Parent or Legal Guardian), my dependent child to attend and participate fully in the activities of JCC MetroWest Aquatics School. I give permission to any licensed medical doctor or nurse to render treatment as deemed necessary. JCC MetroWest will not be held responsible for accidental injury or negligence while attending this school. Providing medical insurance for illness or injury will be the responsibility of the Parent or Legal Guardian.*

I understand
Photo Release: In consideration for promotional and/or publicity value only, I grant permission to JCC MetroWest the irrevocable right to use my name and photograph and/or that of my child for reproduction in any print or electronic medium for advertising, display exhibition, or editorial use.*

I understand
Privacy Statement: In order for the JCC to offer program registration and payment, we must ask you to provide us with information about yourself, including your credit card or debit card and/or bank account details. By using this enrollment method, you expressly consent and authorize the JCC to process your data on your behalf. Your information is kept confidential within the JCC. We will not sell or lend your personal information to third parties for their marketing purposes without your explicit consent.*

I understand
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NJ CANNONS REGISTRATION FORM

Personal Information

TERMS AND AGREEMENT

Please review and check that you agree to the following