NYAC Youth Programs Required Forms

This online form is required for participation in all NYAC Youth Programs including, but not limited to, the Saturday Morning Program, Junior Squash Clinics/Camp, Junior Sailing, Junior Swim and Dive Team, Pre-Team (Swim), Junior Tennis Academy, MITL, Junior Water Polo Team and the Winged Foot Day Camp. It is to be completed by the parent/guardian of the child listed.

An additional online form must be completed for siblings.
Any questions can be directed to Ivelisse Rivera at [email protected].

Child's Name:*
Date of Birth:*	Date and timeNow
Audit #:*
Parent/Guardian Name:*
Email:*
Street Address:*
City:*
State / Province / Region:*
Zip / Postal Code:*
Daytime Telephone(s):*
Consent for Emergency Medical Treatment:	In the case of a medical emergency and I, or the emergency contact, cannot be reached after a reasonable effort has been made, I hereby give permission to the physician selected by the NYAC staff to hospitalize and secure treatment for my child names above. I authorized the release of medical information regarding my child by his/her physician for treatment purposes.
Date:*	Date and timeToday
Emergency Contact Name:*
Text box:*
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