Create an Account - Increase your productivity, customize your experience, and engage in information you care about.
All resident and non-resident members must have a completed Registration and Emergency Contact Form on file. This confidential, mandatory form is required annually to start, or continue to participate, in all Senior Center programs. Refer to our newsletter “The Maple Street Monthly” for information on additional forms that may be required for program participation. Submit all forms and payment, if applicable, to the receptionist prior to activities.
Thank you, Erin R. Graziani, Senior Center Director
Note: Caregiver must also complete a Registration & Release Form.
I have received, read and understand the “HANDBOOK & OPERATING PROCEDURES FOR SENIOR CENTER PROGRAMS”.
In the event photos are taken I hereby give permission for the Senior Center to use said photos in promotional literature, including brochures, flyers and on the website.
To the fullest extent permitted by law, I agree to indemnify and hold harmless the Town of Ellington and its employees from any injuries or damages caused by or resulting from participation in any program offered by the Ellington Senior Center. A photocopy of this waiver form with my signature shall be considered as valid as the original.
This field is not part of the form submission.
* indicates a required field