Você está na página 1de 2

Summer Fitness Classes Registration Form 2013

Participant Name____________________________ Sex____ Date of Birth_______________Age______ Grade in September 2013 (if applicable)_________
Mosholu Montefiore CommunityCenter 3450 DekalbAve. Bronx, NY10467 (718) 882-4000 www.mmcc.org

Summer Fitness Programs

Swimming Karate

Address____________________________Apt._____ City_____________State________Zip____________ Home Phone #_______________________________ Cell Phone #_________________________________ Emergency Name & Phone #___________________ ___________________________________________ Parentss Name______________________________ Business Phone #_____________________________ Parents Name_______________________________ Business Phone #_____________________________

Children

Class/Program

Date/Session

Fee

Adults

Enclosed find $___________ (Dont forget $20 accident insurance) I understand that the Center may take photos for publicity purposes. Parents Signature____________________________ Receipt #____________ Method______________ Insurance___________ Amt. Paid____________

Register Today! June August 2013


Mosholu Montefiore CommunityCenter 3450 DekalbAve. Bronx, NY10467 (718) 882-4000 www.mmcc.org

Summer Swimming Programs at Fordham University Adults and Children


Swim Lessons for Toddlers
Ages 3 4
Mondays Thursdays: 9:00am 9:50am or 11:00am 11:50am Session (8 Classes) & Fees: Session I: July 1st - July 12th No class July 4, extra class on 2nd week as make up Session II: July 15th July 25th Session III: July 29th August 8th Fee: $130 Member/$135 Non member Plus: $20 Accident Insurance

Karate Classes
Ages 5 Adults
Times & Sessions: Monday and/or Wednesday 8 sessions 5:30pm 6:30pm: Kindergarten 3rd grade 6:30pm 7:30pm: 3rd grade 6th grade 7:30pm 8:30pm: Teens Adults Monday Classes: June 24, July 1, 8, 15, 22, 29, August 5, and 12 Wednesday Classes: June 26, July 3, 10, 17, 24, 31 August 7, and 14 Fees: Kindergarten6th grade Once a week: $90 members/$100 nonmembers Twice a week: $140 members/$150 nonmembers Fees: Teens and Adults Once a week: $100 members/ $110 nonmembers Twice a week: $180 members/$190 nonmembers Plus: $20 Accident Insurance, $30 GI Uniform Note: No classes on July 4th

Learn to Swim
Ages 5 15
Mondays Thursdays: 4:00pm, 5:00pm or 6:00pm Session (8 Classes) & Fees: Session I: July 1st - July 12th No class July 4, extra class on 2nd week as make up Session II: July 15th July 25th Session III: July 29th August 8th Fee: $130 Member/$135 Non member Plus: $20 Accident Insurance

Recreational Summer Swimming


Ages 5 15
Mondays Thursdays: 9:00am 12:00pm Session (8 Classes) & Fees: Session I: July 1st - July 12th, $390 No class July 4, extra class on 2nd week as make up Session II: July 15th July 25th, $390 Session III: July 29th August 8th, $390 Full Season: July 15th August 8th, $1,050 Note: Children should bring a morning snack. No classes on July 4th Tuesdays: 7:00pm - 8:00pm Session (8 Classes): June 4, 11, 18, 25, July 2, 9, 16, and 23 Fee: $130 Member/$135 Non member Plus: $20 Accident Insurance Note: No classes on July 4th

Adult Learn to Swim