Oct
    04
    Current Events Discussion Group

    Be a part of a lively discussion on the topic of the day, every first Tuesday and Third Thursday.

  • Oct
    06
    Exploring Broadway: Shall We Dance?

    Journey with James Sokol through various dance numbers of an array of genres – ballet, jazz, Latin, rock & roll, tap and more – from “Golden Age” classics to contemporary classics.

  • Oct
    07
    Table Tennis For Seniors

    Join us every Friday for Senior Table Tennis at The Village at NorthRidge. Get fit and enjoy a healthier lifestyle!

The Jerry Wayne Youth Fall Basketball Clinic Registration

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Name*
MM slash DD slash YYYY
Parent 1 Name*
Parent 2 Name
Primary Policy Holder Name*
Emergency Contact Name*
Please select which options you would like to register for.
Please Select Your Session Choice(s)
Price: $15.00
Price: $0.00
Includes selections above and a 3% processing fee.
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PARENT PERMISSION FORM, LIABILITY WAIVER AND RELEASE, AND AUTHORIZATION FOR MEDICAL/DENTAL TREATMENT I understand that participation in the VJCC/Eclipse basketball camp involves risk and dangers of serious and permanent bodily injury and death. I hereby release, hold harmless, discharge and agree not to sue Eclipse basketball, Ben Yeger, the VJCC, all their affiliates and DBA, all directors, officers, employees, coaches, officials, volunteers, owners/leasers of premises for and from all liability from my participation in and with these and any other related travel, lodging, social and recreational activities. I also understand Eclipse basketball retains the right to use for publicity and advertising, photographs and video taken of the participants. I have given my son/daughter permission to participate in the VJCC/Eclipse Basketball events, and I certify that he is in good health, has been cleared by a physician and can take part in all physical activities not limited to, but including training, practices, and games. I am aware that my son/daughter may become injured. If an injury occurs, I authorize the staff members to take any action and use the emergency service available at the nearest hospital if necessary. I understand my personal insurance will be used in this case. In case of an emergency, I authorize the personnel to take action.
Name*
By typing your name below you are indicating you have read the above Parent Permission form, liability waiver, and release.
Medical Release**
Player Name*
By typing your name below you are indicating you have read the above Parent Permission form, liability waiver, and release.
Parents Code of Conduct**
Waiver**

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