Clone of 2016 Registration Form

Today's date

MonthDayYear

Waive late fee

YesNo

This is an interactive form that can be used to do any, or all, of your Arlington Forest Club sign-ups for 2016. You only will be asked questions that relate to answers that you provide. While we encourage you to register for all activities at once, so you can make a single payment, you can use this form later to register and pay for an activity you are not ready to sign up for today.

Any question with an asterisk (*) must be completed.

When finished, hit the Submit button at the bottom. If you need to reset the form, use the Clear Form button at the bottom.

Membership type*

Certificate Holder (number 1-675)Emeritus Member (EM1-EM99)Tenant of a Certificate Holder (number 676-725)Summer Rental Member (number 2600-2699)August/September Rental Member (number 3600-3699)Waitlist Member (obtain registration number from membership@arlingtonforestclub.org)

Emeritus Member

Just enter your number without EM below

Membership number*

Please email the Membership Manager if you cannot remember your number.

Invoice Number

Office use only

Certificate Holder: What do you want to do today? Check all that are applicable.*

Emeritus Member: What do you want to do today? Check all that are applicable.*

Summer Renter or Tenant: What do you want to do today? Check all that are applicable.*

August/ September Renter: What do you want to do today? Check all that are applicable.*

Wait List Member : What do you want to do today? Check all that are applicable.*

Swim lesson registrationTennis clinic registrationDive lessons

Certificate Holder (or Emeritus Member, or Renter)*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home phone

Primary e-mail*

Confirmation Email

Date of birth

MonthDayYear

Mobile number

Second Certificate Holder (or Emeritus Member, or Renter)

First NameLast Name

Date of birth

MonthDayYear

Mobile Number

E-mail

Confirmation Email

Are there any dependents?*

Select One Response

Dependent 1*

First NameLast Name

Date of birth*

MonthDayYear

Dependent 2*

First NameLast Name

Date of birth*

MonthDayYear

Dependent 3*

First NameLast Name

Date of birth*

MonthDayYear

Dependent 4*

First NameLast Name

Date of birth*

MonthDayYear

Dependent 5*

First NameLast Name

Date of birth*

MonthDayYear

Dependent 6*

First NameLast Name

Date of birth*

MonthDayYear

2016 Dues

Do you wish to prepay the fall 2016 certificate fee increase/assessment?

YesNo

2016 Fee Increase

The Fall 2016 bathhouse payment of $310 must be paid no later than November 1, 2016.

2016 Emeritus Dues

Rental Fee

August Rental Fee

Late Fees

Waived late fee

Guest passes

Each pre-purchased, guest pass is good for 10 guest visits (one guest 10 times, 10 guests 1 time, etc.). Please select how many of these 10-visit guest passes you wish to purchase (members entitled to complimentary guest passes will have them automatically credited to their account) $55 each

Quantity (sets of 10 passes)*

Guest passes fees ($)

Emeritus visits

Each pre-purchased, emeritus visit pass is good for 10 visits to the pool at times not otherwise permitted by your emeritus membership. Please select how many of these 10-visit passes you wish to purchase at $55 each

Quantity (sets of 10 passes)*

Emeritus passes fees ($)

Tennis keys

Number of tennis keys you wish to purchase ($10 will be refunded upon return) $20 each

Quantity

Tennis keys fees ($)

What babysitter pass(es) do you need?

Full season ($75)Early season ($35) Opening til June 24Peak season ($35) June 24 to July 31August/September ($35)

Babysitters (Full Season)

Babysitter's name

Babysitters (Early Season)

Babysitter's name

Babysitters (Peak Season)

Babysitter's name

Babysitters (August/September)

Babysitter's name

Babystitters fee(s) ($)

In order to be on the swim team, families must be current in their AFC dues. In addition to paying swim team fees here, all families must complete the swim team registration process by going to the swim team website. The cost will be $120 for the first swimmer, $110 for the second swimmer, and $90 for the third and each additional swimmer.

Number of swimmers

Swim Team Fee Total ($)

The fees for dive team are $135 per diver. For each diver, please enter the requested information. Note: To register children for the Dive LESSONS (these are separate from the Dive team), please contact Coach Bobby Meeks directly (see the website for lesson information and registration form). This form is for team registration only.

How many divers?*

Diver's name

Winter dive team

Age as of June 1, 2016

Allergies

Medical (diabetes, asthma)

T-shirt size

Diver 2's name

Winter dive team

Age as of June 1, 2016

Allergies

Medical (diabetes, asthma)

T-shirt size

Diver 3's name

Winter dive team

Age as of June 1, 2016

Allergies

Medical (diabetes, asthma)

T-shirt size

Dive team members must provide physician & insurance information.

Physician

Physician phone

Insurance Company

Insurance Policy No

Insurance Phone

Area CodePhone Number

I hereby authorize Arlington Forest Club, Inc., any physician member of the Department of Emergency Medicine, and/or Emergency Medican Technicians to render medical treatment which in his/her judgment may be necessary in the care of my child(ren).

Emergency approval*

Enter name to authorize

Enter date(s) diver and parents are out of town

I would like to help dive team by (choose at least two)*

Dive Team Fees ($)

If you are registering a child for the AFC Juniors Tennis TEAM, the fee will be $75 per child. Note: To register children for the Juniors CLINICS (these are separate from the Juniors teams), please check "Tennis clinic registration" above.

Juniors*

Juniors Fees ($)

Automatically fills when selecting number of players

Name 1

Gender

MaleFemale

Age as of July 2016

Name 2

Gender

MaleFemale

Age as of July 2016

Name 3

Gender

MaleFemale

Age as of July 2016

Parent Volunteering

I can provide transporationI can provide drinks/snacks for a matchOther

Adult Men's Tennis

If you are participating in either the AFC Adult Mens Number 1 or Number 2 team, there is a fee of $25/adult. See the website to determine which team is best for you.

Number

Men's Tennis Fees ($)

Name

Preferred team

#1#2

Name

Preferred team

#1#2

Click for AFC Website Swim Lesson Details including class descriptions.

For swim lessons, identify your child(ren) and then select the appropriate swim class for each session for which you which to register for each child. Please make sure to select the column for a class that corresponds to the column for the child. The lesson cost will be calculated for you.

Registrations close Midnight Thursday before the week classes start. Do NOT register for a class after that date, or your registration will be returned.

Show lessons

MorningEvening

Names of children taking lessons*

	Child 1	Child 2	Child 3	Child 4
Enter name

Morning Lessons (Monday, Tuesday, Wednesday, Thursday, unless noted below)

June 27 to June 30, 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

June 27 to June 30, 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 5 to 8 (Tu, W, Th, F), 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 5 to 8 (Tu, W, Th, F), 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 11 to 14, 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 11 to 14, 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 18 to 21, 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 18 to 21, 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 25 to 28, 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 25 to 28, 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 1 to 4, 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 1 to 4, 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 8 to 11, 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 8 to 11, 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 15 to 18, 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 15 to 18, 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 22 to 25, 9:25 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 22 to 25, 10:05 am

	Child 1	Child 2	Child 3	Child 4
Pick lesson

Evening Lessons (Tuesday, Wednesday, Thursday, unless noted below)

June 27 to 30 (M, Tu, Th), 5:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

June 27 to 30 (M, Tu, Th), 6:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 6 to 8 (W, Th, F), 5:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 6 to 8 (W, Th, F), 6:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 11 to 15 (M, Tu, F), 5:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

July 11 to 15 (M, Tu, F), 6:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 2 to 4, 5:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 2 to 4, 6:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 9 to 11, 5:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 9 to 11, 6:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 16 to 18, 5:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 16 to 18, 6:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 23 to 25, 5:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

August 23 to 25, 6:00 pm

	Child 1	Child 2	Child 3	Child 4
Pick lesson

Number of lessons1

Number of lessons 2

Number of lessons 3

Number of lessons 4

Number of lessons 5

Number of lessons 6

Total number of swim lessons

Swim lesson costs ($)

Juniors Tennis Clinics

SESSION	DATES	SESSION CODE	TIME	COST
Session I	June 27 – July 1, 2016 (except Wed.)	A1: Advanced	8:30 – 10am	$60.00
	"	B1: Beginning	10 – 11am	$40.00
	“	C1: Intermediate	11am – 12noon	$40.00
Session II	July 4 – July 15, 2016 (except Wed.)	A2: Advanced	8:30 – 10am	$120.00
	“	B2: Beginning	10 – 11am	$80.00
	“	C2: Intermediate	11am – 12noon	$80.00
Session III	July 18 – July 29, 2016 (except Wed.)	A3: Advanced	8:30 – 10am	$120.00
	“	B3: Beginning	10 – 11am	$80.00
	“	C3: Intermediate	11am – 12noon	$80.00
Discounted (paid-in-advance) rate for all three beginning/intermediate sessions: $170.00. Discounted (paid-in-advance) rate for all three advanced sessions: $250.00.
TENNIS CAMP All Levels August 8 - 12 9am-12noon $200.00

Juniors Tennis CLINIC involvement last year 2015

How many children taking clinics?*

123

Full Name

First NameLast Name

Gender

MaleFemale

Birth Date

MonthDayYear

Choices

Register by sessionAll three sessions (beginning, intermediate)All three sessions (advanced)Camp

Sessions

Full Name

First NameLast Name

Gender

MaleFemale

Birth Date

MonthDayYear

Choices

Register by sessionAll three sessions (beginning, intermediate)All three sessions (advanced)Camp

Sessions

Full Name

First NameLast Name

Gender

MaleFemale

Birth Date

MonthDayYear

Choices

Register by sessionAll three sessions (beginning, intermediate)All three sessions (advanced)Camp

Sessions

Junior Clinic Fees

There will be six sessions:

Session #1: June 27 - June 30
Session #2: July 4 - July 7
Session #3: July 11 - July 14
Session #4: July 18 - July 21
Session #5: July 25 - July 28
Session #6: August 1 - August 4

All sessions are Monday - Thursday from 10:15 - 10:45 am., with Friday as a make-up lesson in the event of inclement weather.

Lessons are $35 per diver per session ($30 for registered dive team members).

To register, enter your child(ren's) name(s) on the first line. Then, for each session for which you wish to have lessons, select the row corresponding to the child's name and whether they are/are not on the dive team.

Names of children taking lessons*

	Child 1	Child 2	Child 3
Enter name

June 27 to June 30

	On dive team	Not on dive team
Child One
Child Two
Child Three

July 4 to July 7

	On dive team	Not on dive team
Child One
Child Two
Child Three

July 11 to July 14

	On dive team	Not on dive team
Child One
Child Two
Child Three

July 18 to July 21

	On dive team	Not on dive team
Child One
Child Two
Child Three

July 25 to July 28

	On dive team	Not on dive team
Child One
Child Two
Child Three

August 1 to August 4

	On dive team	Not on dive team
Child One
Child Two
Child Three

Number lessons dive team

Number lessons not on dive team

Dive Lesson Fees

10 visit passes ($50)

Select number

5 visit passes ($30)

Select number

Water Aerobic Fees ($)

Amount Due to AFC

Payment method*

Pay by credit cardPay from bank account

Online payment fee

Amount to charge

Credit card payment

USD2016 Registration

Batch

If you wish to pay by e-check, after you click Submit below, you will be taken to a Thank You page which will have an "AFC Payment" button on it, and additional instructions.

If you encounter any problems paying by e-check, please email membership@arlingtonforestclub.org .

2016 AFC Registration Form

Fees

Swim Team Fees

Dive Team Registration

Tennis Teams

Swim Lessons

Child One

Child Two

Child Three

Dive Lessons

Water Aerobics

Payment