Scotia-Glenville Central Schools

Fitness Center

Community Registration Form

Membership Type: Check One

** Scotia-Glenville students between grades 7-12 are eligible to use this facility at no cost once they have successfully completed the orientation class. Children prior to grade 7 are not eligible to participate in the fitness center.

q Single - $100/year from date of registration

q Family - $150/year – this includes any member of your immediate family living in your Scotia-Glenville residency.

q Senior Citizen – Single - $50

q Senior Citizen – Couple - $75

q College Student - $25 or $2/visit (Summer Vacation)

Name ___________________________________________________

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Home Telephone __________________________________________

Work Telephone __________________________________________

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Emergency Contact & Number ______________________________

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Home Address ____________________________________________

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Hours:

§ Regular School Days 5:00pm – 8:30pm

§ Saturdays 8:00am – 11:30am

§ Summer Vacation 5:00pm – 8:30pm

Note:

§ Hours may be available at other times. These would be posted.

§ If school closes due to inclement weather or other catastrophic events, the center is closed.

§ If school dismisses early because of weather or other catastrophic events, the center is closed.

§ All hours are subject to change. Notification will be given at the fitness center ahead of time whenever possible.

Membership Requirements:

§ Proof of residency upon registration

§ You must be in at least the 7^th grade

§ Complete a one hour orientation program

§ A check for the full amount must accompany your registration. The check must be payable to: Scotia-Glenville Central Schools.

§ Checks are non-refundable.

§ You are responsible for any fee associated with a returned check.

Please Note:

§ Entrance: Please park in the back parking lot by the new gym entrance and enter through the double doors next to the lobby. Follow that hallway to the main entrance of the fitness center where the reception desk is located. Signs will be posted.

§ Contest nights: On nights of home Boys’ Basketball games, enter through the new gym lobby and present your membership card before proceeding to the fitness center.

§ There are no shower or locker room facilities available.

§ Scotia-Glenville Central Schools are not responsible for any items lost or stolen. You are encouraged to keep valuables in your locked car.

I understand that participating in a program of exercise may result in injury and I assume and accept all responsibilities for such occurrences. I also realize that I may be suspended from using the facility for not following the rules and regulations of the facility and/or supervisors instructions.

Signature _________________________________________________

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Date of Registration ________________________________________

Paid in Full Amount _________________________________________

Fitness Center Supervisor or Athletic Director Signature

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