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2016-2017 Registration & Release Form

Steps

  1. 1. Step One
  2. 2. Emergency Contact
  • Step One

    1. 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 Revised, 11/01/2016

    2. D o you have any allergies?