TERRYTOWN COUNTRY CLUB

Size: px
Start display at page:

Download "TERRYTOWN COUNTRY CLUB"

Transcription

1 P.O. BOX CAROL SUE AVE GRETNA, LA TERRYTOWN, LA RENEWAL LETTER & DUES NOTIFICATION Dear TCC Member(s): It is that time of the year again and summer will be here before you know it! Enclosed please find our 2018 membership renewal. For accuracy in accounting, record keeping and insurance purposes, we ask that ALL members complete the application/renewal form and return the completed application along with your dues payment prior to May 1, All dues must be paid in full by May 1 st to avoid the $25.00 late fee. Remember, we can accept credit card payments but a small transaction fee applies. If you would like to pay by credit card, please complete the enclosed credit card authorization. Please be sure to include your address on the application, this will assist us in communicating with your family. Please see the attached dues structure - there is a membership level for everyone. If you know of someone who is interested in membership, please forward them a copy of the application. Please keep in mind that all new applicants must be sponsored by current members in good standing of the club and are subject to Board approval. Please take a minute to review our membership guidelines. The pool will open on Saturdays and Sundays beginning May 5, Pool hours are 12:00 noon to 10:00 p.m. on Saturday and from 12:00 noon to 8:00 p.m. on Sunday until Memorial Day weekend. Beginning Sunday, May 27, 2018, summer hours will begin. Also, we are again offering discounted guest passes. The price will be $50.00 for a book of 10 guest passes. Please see a manager to purchase your passes. Guest fees are $7.00 at the gate. Please take a moment to read the Membership Definitions and Application process. Returning members do not need sponsors. In the meantime, please come out and help us make our club beautiful. We will begin Spring Cleaning the first weekend in March. Please come out and help us get the club summer ready and in great shape.

2 We are again excited about our Swim Program for 2018! Last year was amazing and the Tidalwaves placed strong at Meet of Champions against all 12 Clubs. Your 2018 Coaching Team consists of: Tara Aucoin England, Meghan Smith and Sadie Murphy with our JCCA Rep Brigette Murphy at the helm! Swim Team Registration will be held in the club lounge on Saturday, April 21, 2018 from 10am-12pm. Swimmers of all skill levels (ages 4-18 by 6/1/18) are welcome! Please come in to register and meet our Coaches. If you have any questions please contact Brigette Murphy via Terrytown Country Club has partnered with Swim Team On The Raging Mississippi (STORM) to bring year round swimming to the WestBank! In support of STORM Swim Team, TCC will be offering reduced Registration for Tidalwave swimmers who are Registered STORM members. Please contact Brigette Murphy for additional Swim Team info via for additional information on year round swimming visit STORM online at Don t forget about Terrytown Swim Team Sponsorships this a great way to show your support of TCC TIDALWAVE Swim Team. We have two Sponsorship levels available. Your Name or Business Name will be displayed on our 2017 Sponsor Board for the 2017 Season. We have 2 levels available: RIPTIDE Sponsor: $100 Company / Family Name on Sponsor Board (5 letters) TIDALWAVE Sponsor: $200 Company / Family Name on Sponsor Board (5 letters) & Contact info listed on Sponsor PAGE on TCC website We would also like to remind everyone that the Cabana, as well as several other locations throughout the club are available to Members for party rentals. The lounge is also available for rentals during non-operational hours. All parties are three (3) hour rentals (with an additional ½ hour for set up and a ½ hour for clean-up). Please us or see a manager for details and to reserve your date! If you have any questions, comments or suggestions, or would like to volunteer at the club please us at terrytowncountryclub@gmail.com. Don t forget to Like us on Facebook and check our Facebook page for upcoming events. It s going to be another spectacular summer at Terrytown Country Club!!!!!!!!!!! Respectfully, TCC Board of Directors

3 2018 Membership Dues Charter /Stockholder ($325 Dues + $100 Assessment) $ Non-charter / Full Year Family Affiliate Membership $ Non-charter / Single Adult Affiliate Membership 0.00 Athletic Membership */ ages only $ Full payment must be received by 5/1/17. Payments received after this date will be subject to a $25 late fee. We will again accept credit card payments (with an added surcharge of 3.25%). If you wish to pay by credit card, please complete the enclosed credit card authorization. Of course, we are happy to make payment arrangements whenever necessary. Please contact us for a payment schedule to avoid late fees. Late fees will be strictly enforced unless arrangements are made in advance. ALL MEMBERS MUST COMPLETE an application for record keeping and insurance purposes. Please remit your dues and a completed membership application to: TERRYTOWN COUNTRY CLUB PO BOX 1285 GRETNA, LA Membership Category Definitions Charter/Stockholder Membership: Membership for one adult, spouse and dependent children younger than 25 and residing in the same household with guest privileges. Non-charter / Full Year Family Affiliate Membership: Membership for one adult, spouse and dependent children younger than 25 and residing in the same household with guest privileges. Non-charter / Single Adult Affiliate Membership: Membership for one adult with guest privileges. Athletic Membership: Ages 12-18, no guest privileges (please see additional requirements for Athletic Membership) Applications for Athletic membership status must also include: Proof of age in the form of a valid Birth Certificate. Parent s or Legal Guardian s permission signature. Participation on club sponsored athletic team. Payment in full of all fees in connection with participation on club sponsored athletic team.

4 Guidelines for Membership Admission The following guidelines will be utilized by the Membership Admissions Committee in determining the qualification of an applicant for membership. Application: A membership application form must be submitted for review by the Admissions Committee for completeness and accuracy. Letters of recommendation from two current Terrytown Country Club members in good standing, one being a charter member (stockholder). These letters must accompany the application. The application must be signed and dated by the applicant. Application Process All new membership applications are reviewed weekly by the Membership Admissions Committee from March 1 May 1. Each new application will be reviewed by the Membership Admissions Committee. Applications for new membership should be accompanied by a letter of sponsorship from two sponsoring members (one charter/stockholder member sponsor required). Any application received without charter member sponsorship must be interviewed by the Membership Admissions Committee. Results of the interview will be documented by the Membership Admissions Committee and included as part of the recommendation submitted to the Board of Directors for final approval. The Membership Admissions Committee will maintain a current list of qualified applicants in the order each applicant is determined to be qualified, subject to subsequent actions by the applicant when contacted about their membership application. Board of Directors Review of Membership Applications The Board will review membership applications presented to them for consideration by the Membership Admissions Committee and will consider the recommendation of that committee. All applicants are subject to background check and verification of information provided on their application. There will be no discrimination based upon race, religion or sex in the review of applications. Additional Information: 1. Membership dues and fees are subject to change at any time. 2. Annual dues shall become due on May 1st of each year. 3. Dues and entrance fees are payable upon acceptance of Membership invitation.. 4. Membership shall become effective only after all payments have been made or in accordance with a schedule approved by the Board of Directors.

5 2018 Membership Application New Membership Existing Member / Change of Status Type of Membership: Charter Full Year Single Athletic Name: Date of Birth: Address: Home Phone: Employer: Name: Date of Birth: Address: Home Phone: Employer: Name: Applicant Information (Member) Cell Phone: Co- Applicant / Spouse Information Cell Phone: Dependent Information: Age: Please list any pertinent medical information for anyone listed above: Zip Code: EMERGENCY CONTACT: Name: Relationship: Phone No.: Please return the completed application and your payment for membership dues to Terrytown Country Club, P.O. Box 1285, Gretna, LA X Date: Signature acknowledges application is subject to verification and background check. SPONSORED BY: (2 sponsors required for new applicants only) Member # 1 Member # 2

6 Terrytown Country Club Credit Card Authorization Form Payment type: (Circle One) Visa MasterCard Am Ex Name on Credit Card: Credit Card # Expiration Date: Security Code: Zip Code: Amount Charged: $ Signature Authorizing Charge: ALL INFORMATION MUST BE COMPLETED. Please remember a transaction fee of 3.5% + 15 will be added to the amount authorized.

7 2018 JR JCCA Swim Team Registration Swim Team Registration: Saturday, April 21, 10a-12p Member Name: CELL Phone #: contact*: * Please note we communicate via , text message & Facebook regarding Practices, Meets, etc. Yes, I Authorize TCC Swim Team to communicate with me via &/or text. Child s Name Birthdate Age as of 6/1/18 Sex M / F Registration Fee ** (Includes Shirt) T-Shirt: Youth (S-L) or Adult (S- 3X) Shirt Size Subtotal $55 $50 Additional T-Shirts each: Youth $12: YS-YL, Adult $15: S-XL; $18: 2X-3X TOTAL DUE: ** If you are currently registered with STORM, TCC Swim Registration = $20 (Includes Team Shirt) Volunteer Positions (check all that you can assist with): Timer: Ribbon Writer: Cook: Place Picker: Table Worker: Parent Coordinator: Head Table Worker***: Stroke Judge***: ***Requires Attending 1 Training Class (training good for 3 years, class TBA) Each Family is required to work ½ of every meet (Home and Away). If you cannot make a meet the swimmer s family must contact the Parent Coordinator 24 hours prior to the meet to advise who will be your substitute. Your support is crucial to the meet s success. We must have 100% Family participation as we are a small club. Administrative Use only: Amount: Cash/Check# Date: Membership type: Dues Paid: STORM Registration confirmed: Y / N

2019 Renewing Non - Resident Application

2019 Renewing Non - Resident Application 2019 Renewing Non - Resident Application Rye Golf Club 330 Boston Post Road ~ Rye, NY 10580 ~ 914-835-3200 ~ www.ryegolfclub.com RYE GOLF CLUB APPLICATION PROCESS FOR RENEWING NON RESIDENT MEMBERS RESIDENCY

More information

The Muskoka Ski Club 46 years of Family Fun

The Muskoka Ski Club 46 years of Family Fun The Muskoka Ski Club 46 years of Family Fun Thank you for your inquiry into a lifetime Membership with the Muskoka Ski Club. The attached package will provide you with the following information: History

More information

2019 EBENSBURG COUNTRY CLUB MEMBERSHIP AGREEMENT

2019 EBENSBURG COUNTRY CLUB MEMBERSHIP AGREEMENT 2019 EBENSBURG COUNTRY CLUB MEMBERSHIP AGREEMENT This Packet includes the following: 1. Membership Agreement - Must be completed 2. New member contact Information - Must be completed to get discount 3.

More information

Walter F. Ehrnfelt Recreation Center Royalton Road, Strongsville, Ohio

Walter F. Ehrnfelt Recreation Center Royalton Road, Strongsville, Ohio Annual Membership Packages for the Walter F. Ehrnfelt Recreation Center 18100 Royalton Road, Strongsville, Ohio 44136 440.580.3260 www.strongsville.org Fees effective as of October 1, 2014 You now have

More information

2018 Renewing Resident Application. Rye Golf Club 330 Boston Post Road ~ Rye, NY ~ ~

2018 Renewing Resident Application. Rye Golf Club 330 Boston Post Road ~ Rye, NY ~ ~ 2018 Renewing Resident Application Rye Golf Club 330 Boston Post Road ~ Rye, NY 10580 ~ 914-835-3200 ~ www.ryegolfclub.com RYE GOLF CLUB APPLICATION PROCESS FOR NEW AND RENEWING RESIDENT MEMBERS RESIDENCY

More information

MEMBERSHIP APPLICATION FORM

MEMBERSHIP APPLICATION FORM Name of Applicant: Name of Proposer: Name of Sponsor: MEMBERSHIP APPLICATION FORM Date: I/we hereby apply for the membership classification in the Race Brook Country Club, Inc., and agree that if my/our

More information

Birthday Party Application

Birthday Party Application Birthday Party Application Birthday parties are booked based on the completion of this form and a $50 non-refundable security deposit. The party is not confirmed until you have been notified. The birthday

More information

O*H*I*O MASTERS SWIM CLUB (Old Hearts Inspiring Others) CLEVELAND - WEST SIDE Swim Workouts WINTER, 2017

O*H*I*O MASTERS SWIM CLUB (Old Hearts Inspiring Others) CLEVELAND - WEST SIDE Swim Workouts WINTER, 2017 O*H*I*O MASTERS SWIM CLUB (Old Hearts Inspiring Others) CLEVELAND - WEST SIDE Swim Workouts WINTER, 2017 COACHED WORKOUTS for WINTER 2017 - We offer workouts overseen by experienced coaches. All adult

More information

USR LIBRARY MEETING ROOM APPLICATION

USR LIBRARY MEETING ROOM APPLICATION 2018 ALL CORRESPONDENCE TO ann.witkowski@bccls.org Dear Meeting Room Applicant: Enclosed please find the 2018 Meeting Room forms. Last year there were over 1,000 meetings and programs in our meeting rooms.

More information

Duneland Family YMCA General YMCA Member Policy

Duneland Family YMCA General YMCA Member Policy Duneland Family YMCA General YMCA Member Policy I. Mission Statement To put Christian principals into practice through programs that build healthy spirit, mind and body for all. II. Policy of Nondiscrimination

More information

The DuPont Country Club 2018 Membership Application

The DuPont Country Club 2018 Membership Application APPLICANT NO. 1 The DuPont Country Club 2018 Membership Application For questions, call the Membership Office at (302) 421-1722. PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE. APPLICANT INFORMATION OFFICE

More information

2018 ADULT VOLUNTEER APPLICATION

2018 ADULT VOLUNTEER APPLICATION 2018 ADULT VOLUNTEER APPLICATION 1100 Trevilian Way Louisville, KY 40213 (502) 238-5350 (Please Print) Mr. Miss Mrs. Ms. Jr. Sr. Dr II III IV NAME NICKNAME Home Address City State Zip Email Phone Birthdate

More information

Jane Place Neighborhood Sustainability Initiative! Application:! Palmyra Apartments!

Jane Place Neighborhood Sustainability Initiative! Application:! Palmyra Apartments! Thank you for contacting Jane Place Neighborhood Sustainability Initiative regarding rental availabilities at 2739 Palmyra Street. The first step in the process is to complete the enclosed application."

More information

DIVE IN! Speed Demons Swim Team. Fulton Family YMCA 715 W. Broadway Fulton, NY Phone:

DIVE IN! Speed Demons Swim Team. Fulton Family YMCA 715 W. Broadway Fulton, NY Phone: DIVE IN! 2018-2019 Speed Demons Swim Team Fulton Family YMCA 715 W. Broadway Fulton, NY 13069 Phone: 315-598-9622 www.fultonfamilyymca.org 2018-2019 Fulton Speed Demons Registration Participant Name: Date:

More information

Betsy Owens Memorial Lake Swims

Betsy Owens Memorial Lake Swims 14 th Annual Betsy Owens Memorial Lake Swims One Mile and Two Miles Mirror Lake in Lake Placid, New York Saturday, August 15, 2015 Sponsored by: Adirondack LMSC & North Elba Park District Sanctioned by:

More information

BROOKSVILLE GOLF & COUNTRY CLUB APPLICATION FOR MEMBERSHIP

BROOKSVILLE GOLF & COUNTRY CLUB APPLICATION FOR MEMBERSHIP BROOKSVILLE GOLF & COUNTRY CLUB APPLICATION FOR MEMBERSHIP Welcome to Brooksville Golf & Country Club (BGCC). Please complete the following application and member information form as thoroughly as possible.

More information

Looking for the Best Day Camp in South Florida? Look no further! CORAL REEF SPORTS CAMP Day Camp

Looking for the Best Day Camp in South Florida? Look no further! CORAL REEF SPORTS CAMP Day Camp Looking for the Best Day Camp in South Florida? Look no further! CORAL REEF SPORTS CAMP 2016-2017 Day Camp Contents Here s To A Great Winter! Theme Weeks Program Fees/Camp Details & Check In and Out Procedures

More information

DOCUMENT LIST Interim Change Report for Income, Assets, or Expenses

DOCUMENT LIST Interim Change Report for Income, Assets, or Expenses DOCUMENT LIST Interim Change Report for Income, Assets, or Expenses Remember you are required to report all increases in your household income within 10 days of the occurrence. If you are reporting a change

More information

2018 Chambersburg Aquatic Center Rates Approved by Town Council on Monday, 10/16/17

2018 Chambersburg Aquatic Center Rates Approved by Town Council on Monday, 10/16/17 2018 Chambersburg Aquatic Center Rates Approved by Town Council on Monday, 10/16/17 Normal Pool Hours for Daily Admittance: 1-8 PM Category Daily Rates Borough Discounted Rates Adult (Ages 18+) $9 $5 Youth

More information

PATIENT REGISTRATION

PATIENT REGISTRATION First Name Middle Name Last Name Preferred Name PATIENT REGISTRATION Patient Information Byron C. Cotton, M.D., FAAP Gayla Woodson, MSN, CPNP First choice for infants thru young adult! First Patient Second

More information

Copy of all 2017 W-2 forms (Please include W-2 forms for all persons in household). Please cross off social security numbers.

Copy of all 2017 W-2 forms (Please include W-2 forms for all persons in household). Please cross off social security numbers. TRANSFORMING LIVES Open Doors Financial Aid Application Thank you for your interest in the YMCA of Greensboro s financial aid Program. Attached you will find the application for the financial aid Program.

More information

Burgess Elementary School. Procedures and Guidelines Governing Use of School Facilities

Burgess Elementary School. Procedures and Guidelines Governing Use of School Facilities Burgess Elementary School Procedures and Guidelines Governing Use of School Facilities Dear Community Member: This packet contains all the information that you need to reserve school facilities in the

More information

2018 EAST JEFFERSON YMCA Summer Camp Registration

2018 EAST JEFFERSON YMCA Summer Camp Registration Child s Name: _ Grade: Please Circle One: Member Non-Member I will be signing my camper up for Youth Camp C.I.T. Youth Camp (entering grades K-6 th ) Member: 150/Week Non-Member: 190/Week (30/individual

More information

HOMEOWNER APPLICATION

HOMEOWNER APPLICATION About Us: is an all-volunteer registered non-profit organization that provides entirely free home repair services for low-income homeowners and non-profit facilities. We are part of the Rebuilding Together

More information

Parent & Camper Handbook/Manual

Parent & Camper Handbook/Manual SLAM Sports Summer Camp Parent & Camper Handbook/Manual 2014 SLAM 5 5 5 SLAM 326-0003. SLAM SLAM SLAM Charter schools's d SLAM Academy 25.00 9:00 4 120.00 SLAM 5 5 SLAM SLAM SLAM SLAM main lobby of the.

More information

2019 Membership Rates

2019 Membership Rates 2019 Membership Rates Rosedale Beach Club 5401 3rd St Verona, PA 15147 www.rosedalebeachclub.com Dear Fellow Rosedale Beach Club Members, It is time again to start thinking about next season. We had a

More information

FACILITY RENTAL APPLICATION *Application approval is based on facility availability, staffing demands and event specifics.

FACILITY RENTAL APPLICATION *Application approval is based on facility availability, staffing demands and event specifics. FACILITY RENTAL APPLICATION *Application approval is based on facility availability, staffing demands and event specifics. Name/: Date & Day of Event: Start Time: End Time: *see page 2 for set times available

More information

BOWLING LEAGUE BEGINS NOVEMBER 18 BASKETBALL LEAGUE BEGINS JANUARY 7 10/17/17

BOWLING LEAGUE BEGINS NOVEMBER 18 BASKETBALL LEAGUE BEGINS JANUARY 7 10/17/17 BOWLING LEAGUE BEGINS NOVEMBER 18 BASKETBALL LEAGUE BEGINS JANUARY 7 10/17/17 STAFF INFORMATION Program Information Dan Lancianese Sports Supervisor dlancianese@udsakron.org 330-352-5602 Registration Information/Payment

More information

Dear Junior Rower, Coaching Staff: Novice Girls- Jade Nelson Novice Boys- John Kolenda

Dear Junior Rower, Coaching Staff: Novice Girls- Jade Nelson Novice Boys- John Kolenda Dear Junior Rower, We would like to invite you to join the Austin Rowing Club Juniors team for our fall 2016 season! No experience necessary! We are entering our 28 th year and are very excited about the

More information

Quick Reference Guide

Quick Reference Guide Driver s License State Issued Federal Government Driver s License State Issued Federal Government NO YES NO Quick Reference Guide Merchant Services Hotline 800-333-108 Hours: Monday-Saturday 8:00am-10:00pm

More information

HELPING TEENS THRIVE. Youth & Government CENTRAL YMCA

HELPING TEENS THRIVE. Youth & Government CENTRAL YMCA HELPING TEENS THRIVE Youth & Government CENTRAL YMCA LEARN MORE WHAT IS YOUTH & GOVERNMENT? Learn first-hand how our state government works not by watching, but by doing! Each September for six months,

More information

LOCATION & DIRECTIONS:

LOCATION & DIRECTIONS: to benefit Malachi Center s 27th Annual Lake Erie Open Water Swim Urban Kids Swim Camp Sponsered by O*H*I*O Masters Swim Club, Saturday, July 16, 2016 Sanctioned by: Lake Erie LMSC for USMS Inc. EVENTS:

More information

Birthday Party Application

Birthday Party Application Birthday Party Application Birthday Parties are booked based on the completion of this form and $50 non-refundable security deposit to our Children & Youth Department Manager. Party is not confirmed until

More information

RHONEWOOD PARK HOMEOWNERS ASSOCIATION P.O. BOX 263 LIVERMORE, CA KEYED ENTRY ACCESS REQUEST FORM

RHONEWOOD PARK HOMEOWNERS ASSOCIATION P.O. BOX 263 LIVERMORE, CA KEYED ENTRY ACCESS REQUEST FORM P.O. BOX 263 LIVERMORE, CA 94551 667-6647 KEYED ENTRY ACCESS REQUEST FORM Pool Manager: Dayna Key 667-6647 Business Manager: Julie Steinhorst 250-9807 SCHEDULE KEY FEE May 1 through October 30 (weather

More information

Membership Application

Membership Application Membership Application 25 Club Road Newton, NJ 07860 (973) 383-4817 www.newtoncountryclub.org Type of Membership Desired Check One: Membership Category Pre-Paid Golf Member Dues Total Dues -25% Discount

More information

Adult / Age Group Program Information

Adult / Age Group Program Information Adult / Age Group Program Information Welcome to the Sheldon Triathlon Club! The Sheldon Triathlon Club is led by Head Coach, Mr Chris Lang and Club Manager, Mr Jarrod Pleass, with oversight from Sheldon

More information

ANNUAL LAKE ERIE OPEN WATER CLASSIC

ANNUAL LAKE ERIE OPEN WATER CLASSIC Sunday, July 19, 2015 Sanction Number: EVENT INFORMATION EVENTS: There will be ½-Mile, 1-mile and 2-mile swims on a triangular course in Lake Erie. The start will be in the water. The finish will be on

More information

Granada Associates. Dear Applicant:

Granada Associates. Dear Applicant: Dear Applicant: Attached please find the rental application which you have requested. Please note that ALL information, including the information requested on the Addendum to the Application, Form 92006

More information

FLYERS AFTER SCHOOL PROGRAM APPLICATION FOR CHILD. Childs Information. Date of Application: Child s Name (first & last name)

FLYERS AFTER SCHOOL PROGRAM APPLICATION FOR CHILD. Childs Information. Date of Application: Child s Name (first & last name) FLYERS AFTER SCHOOL PROGRAM 2014-2015 APPLICATION FOR CHILD *All information must be complete in order to enroll Childs Information Child s Name (first & last name) Name of School and Grade Date of Birth

More information

Be a Tour of Texas Power League Warm-up Exhibitor.Here s why!!!

Be a Tour of Texas Power League Warm-up Exhibitor.Here s why!!! Be a Tour of Texas Power League Warm-up Exhibitor.Here s why!!! In 2015 the Tour Warm Up welcomed close to 250 teams to Austin. More than 8,000 people are expected to attend the two day event. Volleyball

More information

additional $785 additional $390 additional $195

additional $785 additional $390 additional $195 ADDITIONAL PRIVILEGES Also available to our Members are facility rentals, access to most JCCs nationwide, member-only publications, priority registration, membership discount on programs and so much more!

More information

Miami Beach Rowing Club 2016 Summer Camp

Miami Beach Rowing Club 2016 Summer Camp Miami Beach Rowing Club s Head Coach Vladimir Matovic and his experienced staff are ready to challenge new and experienced rowers to reach their potential in both sweep and sculling. MBRC s rowing camp

More information

LAUREL SPRINGS HOA POOL PARTY REQUEST FORM 2018

LAUREL SPRINGS HOA POOL PARTY REQUEST FORM 2018 LAUREL SPRINGS HOA POOL PARTY REQUEST FORM 2018 To request a pool party, please do the following: Fill out this form and bring to it to the Property Management Office. Go to Sweetwater Pools @ www.sweetwaterpools.net

More information

2018 BELLE CHASSE YMCA Summer Camp Registration

2018 BELLE CHASSE YMCA Summer Camp Registration Child s Name: _ Grade Entering: Pre-School (3-4 years old, must be potty trained) Member: 145/Week Non-Member: 185/Week (30/individual or 50/family one time registration fee) Youth Camp (entering grades

More information

Badlands Motocross Park

Badlands Motocross Park Badlands Motocross Park 5423 County Road 1095, Celeste, Texas 75423 Badland s Main line: (972) 742-2228 Website: www.badlandsmx.com Dear Members, Badlands is now offering Practice Memberships! Full Year:

More information

SPONSORED BY: February 22, Dear Vendor:

SPONSORED BY: February 22, Dear Vendor: February 22, 2018 Dear Vendor: Opportunity Knocks! You are invited to participate in the 4th Annual Deadwood 3 Wheeler Rally, July 10-15, 2018 in Deadwood, South Dakota. This year we are offering outdoor

More information

OPEN DOORS FINANCIAL AID APPLICATION

OPEN DOORS FINANCIAL AID APPLICATION OPEN DOORS FINANCIAL AID APPLICATION Applicant Information Adult (or parent/guardian if applicant is a youth) Last First M.I. Gender DOB_ Street City State Zip Code Home / Cell Phone: Work Phone: E-mail:

More information

ration Form Registr Paddler 1 Paddler 2 if Tand Race Printed Name: Date of Birth: Phone: Zip: Date Zip: Phone: Single Race Kayak Youth (Ages dem

ration Form Registr Paddler 1 Paddler 2 if Tand Race Printed Name: Date of Birth: Phone: Zip: Date Zip: Phone: Single Race Kayak Youth (Ages dem 2017 Annual Lampasas Spring Ho Festival Kayak Races Race Day Saturday July 8, 2017 See Division Categories for Start times Early Registration thru July 6th, $5 Registration on Day of Race, $10 Printed

More information

Savannah Children s Choir

Savannah Children s Choir Savannah Children s Choir 2015/2016 Fees Fundraising Financial Aid Forms 2015/2016 Payment Schedule at a Glance August 15 August 31 / September 1 October 5/6 November 2/3 November 30/ December 1 February

More information

BE A PART OF SOMETHING GREATER Membership Application BRAD AKINS BRANCH

BE A PART OF SOMETHING GREATER Membership Application BRAD AKINS BRANCH BE A PART OF SOMETHING GREATER Membership Application BRAD AKINS BRANCH YMCA Mission: To put Christian principles into practice through programs that build healthy spirit, mind, and body for all. Because

More information

What: USE THE POOL OR CLUBHOUSE FOR YOUR PRIVATE EVENT. When: Check calendar availability for your event

What: USE THE POOL OR CLUBHOUSE FOR YOUR PRIVATE EVENT. When: Check calendar availability for your event Saratoga Woods HOA Newsletter The Board will be hosting Walk With a Cop on Saturday morning, March 18, 2017. Officer Miller and Stuart Benson will be walking in the neighborhood with Board Members to discuss

More information

APPLICATION FOR SCHOOL BUS DRIVER FOR THIS TYPE OF EMPLOYMENT, STATE LAW REQUIRES A CRIMINAL CHECK AS A CONDITION OF EMPLOYMENT

APPLICATION FOR SCHOOL BUS DRIVER FOR THIS TYPE OF EMPLOYMENT, STATE LAW REQUIRES A CRIMINAL CHECK AS A CONDITION OF EMPLOYMENT APPLICATION FOR SCHOOL BUS DRIVER Schley County Board of Education 161 Perry Drive PO Box 66 Ellaville, Georgia 31806 FOR THIS TYPE OF EMPLOYMENT, STATE LAW REQUIRES A CRIMINAL CHECK AS A CONDITION OF

More information

STAY ACTIVE STAY CONNECTED AT THE PISCATAQUIS REGIONAL YMCA

STAY ACTIVE STAY CONNECTED AT THE PISCATAQUIS REGIONAL YMCA STAY ACTIVE STAY CONNECTED AT THE PISCATAQUIS REGIONAL YMCA WE RE MORE THAN A GYM, we are a community committed to strengthening bodies, minds, and spirits. Since 1988, the Piscataquis Regional YMCA has

More information

T H E H E A LT H CLU B M E M B E R S H I P

T H E H E A LT H CLU B M E M B E R S H I P T H E H E A LT H CLU B M E M B E R S H I P MEMBERSHIP TYPE ANNUAL RATE 1 year single membership 550 1 year couple membership 1000 1 year family membership 2 adults + 2 children 1250 Golden Years (60 years

More information

UH Cougar Cub Summer Camp 2017 Registration Form (Please complete one form per camper)

UH Cougar Cub Summer Camp 2017 Registration Form (Please complete one form per camper) UH Cougar Cub Summer Camp 2017 Registration Form (Please complete one form per camper) CAMPER INFORMATION Child s Name: Child s age 6/1/17: DOB Grade by 9/1/17 Gender: (check) M F Street Address City State

More information

RESIDENCY QUESTIONNAIRE

RESIDENCY QUESTIONNAIRE ADMISSIONS & RECORDS OFFICE 1900 Pico Blvd. Santa Monica, CA 90405 Phone: 310-434-4380 Fax: 310-434-3645 RESIDENCY QUESTIONNAIRE Received by: Date: The information requested is deemed relevant and necessary

More information

FINANCIAL ASSISTANCE APPLICATION: COVER LETTER

FINANCIAL ASSISTANCE APPLICATION: COVER LETTER FINANCIAL ASSISTANCE APPLICATION: COVER LETTER Thank you for choosing Children s of Alabama to provide for the healthcare needs of your child. Please find attached the forms you must complete in order

More information

Volunteer Application State 4-H Positions Team Trip Coach/Chaperone

Volunteer Application State 4-H Positions Team Trip Coach/Chaperone Volunteer Application State 4-H Positions Team Trip Coach/Chaperone SECTION I Name: Last First Middle Mailing Address: Street City State Zip Home Phone: Work Phone: Cell Phone: E-mail: 4-H County/City:

More information

Last Name First Name Middle. Address Number & Street City State Zip Code. Date of Birth Applicant Co-applicant / / / / Month Day Year Month Day Year

Last Name First Name Middle. Address Number & Street City State Zip Code. Date of Birth Applicant Co-applicant / / / / Month Day Year Month Day Year PARKVIEW APARTMENTS HOUSING APPLICATION Mr. Ms. Miss Date: Mrs. Mr. & Mrs. Last Name First Name Middle Address Number & Street City State Zip Code ( ) ( ) Home Phone Number Alternate Contact Number How

More information

TITLE (MR, MRS, DR) FIRST NAME MI LAST NAME SUFFIX (SR, JR, II) FOR INTERNAL USE ONLY SO THE YMCA CAN COMMUNICATE IMPORTANT MEMBER INFORMATION

TITLE (MR, MRS, DR) FIRST NAME MI LAST NAME SUFFIX (SR, JR, II) FOR INTERNAL USE ONLY SO THE YMCA CAN COMMUNICATE IMPORTANT MEMBER INFORMATION GATEWAY REGION YMCA MEMBERSHIP APPLICATION AND GUEST REGISTRATION Welcome to the Y! The Y is a charitable not for profit community organization committed to nurturing the potential of kids, promoting healthy

More information

Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship:

Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Member Information Applicants Name: Co-Applicants Name: Membership Application Please read and complete thoroughly all fields and pages of the application. Incomplete applications will be returned to the

More information

STAY ACTIVE STAY CONNECTED AT THE BANGOR YMCA

STAY ACTIVE STAY CONNECTED AT THE BANGOR YMCA STAY ACTIVE STAY CONNECTED AT THE BANGOR YMCA Get Our App on your Mobile Device! WE RE MORE THAN A GYM, we are a community committed to strengthening bodies, minds, and communities. Since 1867, The Bangor

More information

City of Becker Employment Application

City of Becker Employment Application Date Received: Received By: City of Becker Employment Application Return to: Becker Community Center PO Box 250 Becker, MN 55308 Ph: 763-200-4271 Fax: 763-261-2018 Applicant Name: Last First Middle Initial

More information

Membership Scholarship Application

Membership Scholarship Application Membership Scholarship Application Please be advised that all required documents must be fully completed and turned in together in order to be processed. All documents must be legibly written in black

More information

RETAIN THIS SHEET FOR YOUR INFORMATION AND MAIL ENTRY FORM

RETAIN THIS SHEET FOR YOUR INFORMATION AND MAIL ENTRY FORM REVISED 01/20/08 SIXTH ANNUAL AAU TRIPLE CROWN CLASSIC 2008AAU EAST COAST BENCH PRESS CLASSIC 2008 AAU MILITARY NATIONALS FULL POWER 2008 AAU MILITARY NATIONALS BENCH PRESS ENTRY DEADLINE: APRIL 20, 2008

More information

New England Patriots Marathon Team 2014 (NEPCF Marathon Team)

New England Patriots Marathon Team 2014 (NEPCF Marathon Team) New England Patriots Marathon Team 2014 (NEPCF Marathon Team) All pages of this application must be completed. Selections will be made until all spots are filled on the team. Completion of this application

More information

MARYLAND GOLF. and Country Clubs Application for Membership East MacPhail Rd Bel Air Maryland

MARYLAND GOLF. and Country Clubs Application for Membership East MacPhail Rd Bel Air Maryland MARYLAND GOLF and Country Clubs Application for Membership 1335 East MacPhail Rd Bel Air Maryland 21015 410-879-2025 www.marylandgcc.org 1 Category Pricing Current Initiation Fee Monthly Dues Food Minimum

More information

DEPARTMENT OF PUBLIC LIBRARIES

DEPARTMENT OF PUBLIC LIBRARIES DEPARTMENT OF PUBLIC LIBRARIES Policies Title: Library Card External Policy Number: VBPL-POL-0005 Effective Date: April 20, 2016 Date of Revision: January 24, 2018 1.0 Purpose Virginia Beach Public Library

More information

To apply for the Colorado HIBI program, fill out the attached application and return it with all the required documents listed below:

To apply for the Colorado HIBI program, fill out the attached application and return it with all the required documents listed below: Date [First Name] [Last Name] [Address] [City], [ST] [Zip] Dear Applicant, The Colorado Health Insurance Buy-In (HIBI) Program may reimburse health insurance premiums for a Medicaid client if the cost

More information

AWAY FROM HOME CARE GUEST MEMBERSHIP APPLICATION

AWAY FROM HOME CARE GUEST MEMBERSHIP APPLICATION AWAY FROM HOME CARE GUEST MEMBERSHIP APPLICATION Please print clearly. Application must be completed and signed by the subscriber. All five pages must be completed and returned. Today s date: Guest membership

More information

IMPORTANT INFORMATION - READ and KEEP THESE 3 PAGES! DO NOT hand them in with your application.

IMPORTANT INFORMATION - READ and KEEP THESE 3 PAGES! DO NOT hand them in with your application. 2018 SUMMER YOUTH EMPLOYMENT PROGRAM (SYEP) Allegany County Employment & Training, 7 Wells Lane, Belmont, NY 14813 (585) 268-9445 weiricsb@alleganyco.com What is SYEP 2018? IMPORTANT INFORMATION - READ

More information

Please fill out the application, attach the necessary documents and return to the YMCA.

Please fill out the application, attach the necessary documents and return to the YMCA. The Greater Marinette-Menominee YMCA strives to provide membership and program services to all that desire to participate. The YMCA s Financial Assistance Program, supported through contributions to the

More information

LOMPOC AQUATIC CENTER RENTAL INFORMATION EFFECTIVE FEBRUARY 1, 2012

LOMPOC AQUATIC CENTER RENTAL INFORMATION EFFECTIVE FEBRUARY 1, 2012 LOMPOC AQUATIC CENTER RENTAL INFORMATION EFFECTIVE FEBRUARY 1, 2012 Thank you for your interest in renting the Lompoc Aquatic Center. Please read the following information and acquaint yourself with the

More information

May 17, 2017 UNR Equestrian Center Reno, NV

May 17, 2017 UNR Equestrian Center Reno, NV May 17, 2017 UNR Equestrian Center Reno, NV The due date for complete applications to be received by the State 4-H Office in Reno is May 5, 2017. Please note that your application requires the signature

More information

Karen McCallum. Volunteer- Counselor in Training Applications. Spring Dear Counselor in Training Applicant:

Karen McCallum. Volunteer- Counselor in Training Applications. Spring Dear Counselor in Training Applicant: Volunteer- Counselor in Training Applications Spring 2018 Dear Counselor in Training Applicant: Boardman Park Adventure Day Camp Program prides itself on its reputation for quality and service. This recognition

More information

If your monthly household income meets the guidelines below, we invite you to apply:

If your monthly household income meets the guidelines below, we invite you to apply: Bringing energy affordability to Michigan. Thank you for your interest in applying for the Consumers Energy CARE Program. CARE is a 2-year affordable payment plan for income-qualified customers of Consumers

More information

DANVILLE FAMILY YMCA SCHOLARSHIP APPLICATION

DANVILLE FAMILY YMCA SCHOLARSHIP APPLICATION DANVILLE FAMILY YMCA SCHOLARSHIP APPLICATION 1 This is an application for financial aid toward YMCA membership and program fees. Please note that applying for financial assistance does not mean you will

More information

Hoops for Hope. Team Registra on Packet. Team Division (check one): 10th 12th grade (as of me of tournament)

Hoops for Hope. Team Registra on Packet. Team Division (check one): 10th 12th grade (as of me of tournament) December 8, 2013 3-on-3 Hoops for Hope Basketball Tournament Team Registra on Packet Team Team Division (check one): 8th 9th grade (as of me of tournament) 10th 12th grade (as of me of tournament) Athlete

More information

*If you are under the age of 18 years old and applying for a job, do you have a work permit? Yes or No

*If you are under the age of 18 years old and applying for a job, do you have a work permit? Yes or No Wildlife Wonders/North Georgia Zoo Job & Volunteering Application Note: All answers must be printed or typed. Answers that are illegible or incomplete may preclude this application for consideration. Applicants

More information

Mt. Shasta Security Deposit Assistance Program

Mt. Shasta Security Deposit Assistance Program Mt. Shasta Security Deposit Assistance Program The Security Deposit Assistance Program (SDAP) is a Community Development Block Grant (CDBG) funded program for households living within the city limits of

More information

Somervell County Horse Camp

Somervell County Horse Camp 25th Annual Somervell County Horse Camp June 3, 4 & 5, 2013 What is Horse Camp? This hands-on camp conducted by collegiate and professional horseman teaches functional horsemanship and improves horse training

More information

Sabates Eye Centers P.O. Box Kansas City, MO (913)

Sabates Eye Centers P.O. Box Kansas City, MO (913) Sabates Eye Centers P.O. Box 26425 Kansas City, MO 64196-6425 (913) 261-2020 Type of Visit: u Routine u Medical Contact Lens Wearer? u Yes u No PATIENT INFORMATION Name (Last, First, Middle Initial) Date

More information

PARK DISTRICT OF OAK PARK INDEPENDENT CONTRACTOR GUIDE

PARK DISTRICT OF OAK PARK INDEPENDENT CONTRACTOR GUIDE PARK DISTRICT OF OAK PARK INDEPENDENT CONTRACTOR GUIDE 218 Madison Street Oak Park, IL 60302 www.pdop.org 708-725-2000 Introduction WELCOME The Park District of Oak Park is a progressive municipal agency

More information

Street Address: State: Zip: Phone: Registration Form

Street Address: State: Zip: Phone:   Registration Form 2018 Annual Lampasas Spring Ho Festival Kayak Races Race Day Saturday July 14, 2018 See Division Categories for Start times Early Registration thru July 12th, $10 Registration on Day of Race, $15 Paddler

More information

Saturday, April 14, :00am 2:00pm Typhoon Texas 555 S. Katy Fort Bend Rd Katy, TX

Saturday, April 14, :00am 2:00pm Typhoon Texas 555 S. Katy Fort Bend Rd Katy, TX Join us! Saturday, April 14, 2018 10:00am 2:00pm Typhoon Texas 555 S. Katy Fort Bend Rd Katy, TX 77494 www.safetyfestkaty.org Katy Area Safety Fest, in coordination with local Law Enforcement, Emergency

More information

Coaching Staff: First Day of Spring Practice: Wednesday, January 3rd at 5:15pm, Stronghorn and Co.

Coaching Staff: First Day of Spring Practice: Wednesday, January 3rd at 5:15pm, Stronghorn and Co. Dear Athletes, We would like to invite you to join the Austin Rowing Club Juniors team for our Spring 2018 season. The team is entering its 28th year and we are very excited about the upcoming season.

More information

DUNELAND FAMILY YMCA MEMBERSHIP APPLICATION FOR OFFICE USE ONLY

DUNELAND FAMILY YMCA MEMBERSHIP APPLICATION FOR OFFICE USE ONLY DUNELAND FAMILY YMCA MEMBERSHIP APPLICATION FOR OFFICE USE ONLY Please fill out a form for each new member, for members who have renewed, for changes in membership information, or banking information.

More information

SWAN LAKE ESTATES HOMEOWNER S ASSOCIATIONS QUARTERLY NEWSLETTER Second Quarter 2012

SWAN LAKE ESTATES HOMEOWNER S ASSOCIATIONS QUARTERLY NEWSLETTER Second Quarter 2012 SWAN LAKE ESTATES HOMEOWNER S ASSOCIATIONS QUARTERLY NEWSLETTER Second Quarter 2012 President s Message Hi Neighbors, Please be sure to find us on www.facebook.com Summer is just about in full swing, and

More information

Child Care Assistance Application

Child Care Assistance Application Child Care Assistance Application P.O. Box 130 Denton, Texas 76202 Local: 940-382-5619 Toll Free: 1-800-234-9306 Fax: 940-323-4394 or 940-320-5017 or 940-320-5010 www.dfwjobs.com Email: childcare@dfwjobs.com

More information

Request for Benefits. For use with Forms 08MP002E and 08MP003E

Request for Benefits. For use with Forms 08MP002E and 08MP003E *PS1 * Date: Case name: Case number: County number. Supervisor/worker number: / Request for Benefits For use with Forms 08MP002E and 08MP003E What you need to do to get started: Read the following descriptions

More information

Session I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church

Session I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church th Session I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church Session II: June 12th - June 16th, Performance June 13th; Music On Wheels Academy Music Camp

More information

You shall love your neighbor as yourself. Matthew 22:39.

You shall love your neighbor as yourself. Matthew 22:39. You shall love your neighbor as yourself. Matthew 22:39. NRI - Neighborhood Revitalization Initiative is a program created by St. Joseph Habitat for Humanity to more effectively meet the needs of the community

More information

SUBJECT: APPLICATION FOR RESIDENCY

SUBJECT: APPLICATION FOR RESIDENCY SUBJECT: APPLICATION FOR RESIDENCY COMMUNITY: PROGRAM: ORIGINAL DATE: TIME: UPDATE: TIME: HOW DID YOU HEAR ABOUT US? APPLICANT NAME: APARTMENT SIZE: CURRENT ADDRESS: CITY STATE, ZIP: HOME PHONE #: WORK

More information

TEXAS POLICE ASSOCIATION 116 TH ANNUAL TRAINING CONFERENCE June 8 10, 2015 South Padre Island, Texas

TEXAS POLICE ASSOCIATION 116 TH ANNUAL TRAINING CONFERENCE June 8 10, 2015 South Padre Island, Texas Dear Friend: Please accept this invitation to partner with the Texas Police Association and South Texas Area Law Enforcement Agencies in hosting the 116 th Annual Texas Police Association Training Conference

More information

Pool/Tennis Membership Family Pool/Tennis Only ($600) Single Pool/Tennis Only ($300) Range Plan, Bag Storage, and Trail Fee

Pool/Tennis Membership Family Pool/Tennis Only ($600) Single Pool/Tennis Only ($300) Range Plan, Bag Storage, and Trail Fee Full Access Membership - (Includes Golf, Pool and Tennis) Family ($2100/yr or $183.34/mo for 12 mo.) Single ($1800/yr or $158.34/mo for 12 mo.) Active Duty/Retired Military Family ($1900/yr or $166.67/mo

More information

Summer Enrichment Program Application

Summer Enrichment Program Application Child s : LAST Summer Enrichment Program Application FIRST Parent/Guardian s : LAST FIRST Address: STREET CITY STATE ZIP Phone: Home (607) Work (607) Cell Phone (607) of Birth: Do you have available transportation:

More information

COHASSET GOLF CLUB APPLICATION FOR MEMBERSHIP

COHASSET GOLF CLUB APPLICATION FOR MEMBERSHIP COHASSET GOLF CLUB APPLICATION FOR MEMBERSHIP Established in 1894, Cohasset Golf Club is one of the oldest private clubs in New England. Members enjoy a challenging 18-hole Donald Ross course, practice

More information

2018 Youth Academy Parent/ Guardian Agreement with NUS s Continuing Education

2018 Youth Academy Parent/ Guardian Agreement with NUS s Continuing Education 2018 Youth Academy Parent/ Guardian Agreement with NUS s Continuing Education Welcome to NSU Youth Academy! We are excited to have your child with us. In order to provide the best experience for our students

More information

** Important Notice to Summer Camp Program Parents ** Kiddie, Day, and Youth In Action ** Leaders Club

** Important Notice to Summer Camp Program Parents ** Kiddie, Day, and Youth In Action ** Leaders Club ** Important Notice to Summer Camp Program Parents ** Kiddie, Day, and Youth In Action ** Leaders Club As a new year of Kent County Parks and Recreation Summer Camp fun is quickly approaching, we want

More information

Emergency Medical Release & Liability Waiver

Emergency Medical Release & Liability Waiver Emergency Medical Release & Liability Waiver Participant s Name Birthdate Street Address City Zip EMERGENCY INFORMATION Father's Name Home Phone ( ) Cell/Bus Phone ( ) Mother's Name Home Phone ( ) Cell/Bus

More information