Camp & Event Registration - Columbia Athletic Clubs

Participant Information

Participant Name*

First Last

Date of Birth*

Age

Participant is a:*

Member
Non-member

Do we have your permission to use your childs photo/video for Columbia Athletic Club Silver Lake?*

Yes
No

Reservation Request For

Camps / Events / Activities 1

Camps / Events / Activities 2

Camps / Events / Activities 3

Camps / Events / Activities 4

Camps / Events / Activities 5

Camps / Events / Activities 6

Contact Information

Contact Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Emergency Contact Person*

Emergency Contact Phone*

Comments

Refund Policy

A refund/credit will be granted if the withdrawal or cancellation request is received at least 1 week prior to camp. No refund/credit will be granted with less than 1 week notice.

Payment must be received at time of registration.

I understand that my enrollment is not complete and my child’s spot is not saved until payment is collected.

I accept full responsibility for my child's use of any and all apparatus, appliances or facility privilege or service whatsoever, owned and operated by Columbia Athletic Clubs at their own risk and shall hold the Club, its shareholders, directors, officers, employees, representatives, and agents harmless from any and all loss, claim, injury damage or liability sustained or incurred by my child resulting therefrom.

Name

This field is for validation purposes and should be left unchanged.

Silver Lake Camp & Event Registration

Participant Information

Reservation Request For

Contact Information

Refund Policy

INSPIRING HEALTHIER LIVES SINCE 1981