Silver Lake Little Thinkers Registration

Participant Information

Participant Name*

First Last

Date of Birth*

Age

Participant is a:*

Child Registation 1

Child Registation 2

Would you like to set up a tour?

Contact Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Emergency Contact Person*

Emergency Contact Phone*

Comments

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.

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