Berwyn Squash and Fitness Club

The Friendly Little Squash and Fitness Club

 

 

Berwyn’s Junior National

Team

Registration and Commitment Form 2008/2009

 

Name__________________________ DOB_____________

 

Mother’s Name_____________________ Tel# Home:___________

 

Cell:_________________ Email____________________________

 

Father’s Name______________________ Tel# H:________________

 

Cell:_________________ Email_____________________________

 

Cost: $600 payable before Sept. 15th

Mail or Fax Registration form and make Check payable to:

Berwyn Squash and Fitness Club

625 Cassatt Rd Berwyn, PA 19312

Must be received by Sept. 15th

 

Liability Waiver: I agree to hold Berwyn Squash and Fitness Club their employees, agents, directors, and officers harmless from any and all loss, claim, injury, damage or liability sustained incurred by me as a result of my participation in Berwyn’s National Junior Program 2008/2009. All participants in this program must be current members of Berwyn Squash and Fitness Club.

Signature of the Parent:___________________ Date_______________________________