Space is limited; if there are additional days to your preferred choice noted above that may work to enroll your child(ren), please list them below so we can put them in the first available spot. Also, submit anything we need to know upon enrolling your athlete into our program.

I, the undersigned parent or legal guardian of the athletes listed, do hereby authorize the Staff or Independent Contractors of the Bay Club - Manhattan Country Club to act as agents for the undersigned to order X-ray examination, anesthetic, medical, dental, surgical diagnostics, or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or specific supervision of any physician or surgeon licensed under the provision of the Medicine Practice Act on the medical staff of a licensed hospital, whether such a diagnosis or treatment is rendered at the office of said physician or at the said hospital. I further agree that the Bay Club Company, Manhattan Country Club, Staff, and Independent Contractors are hereby relieved of all legal or financial liability in the event of accident or injury to said minor. I also understand that the Manhattan Country Club ("MCC") may take photographs, video and other image and sound-based media of the club, and its employees, members, and visitors. MCC may wish to use such photographs for promotional, advertising, and other purposes. This permission for release, without compensation or prior notice, would allow MCC to use photographs in its printed publications, website, and otherwise. Therefore, I herby freely and voluntarily consent to the use and publication of said media by MCC.