Junior Summer Program REGISTRATION

Child's Full Name:*
Child's Date of Birth:*
Member Number:*
E-mail:*
Emergency Contact:
Contact Phone #:	()-First three digitsSecond three digitsLast four digits
Fees:	Golf $300.00 per child Swim & Tennis $300.00 per child
Golf Program:*	Yes No
Swim Program:*	Yes No
Tennis Program:*	Yes No
Welcome NIght:	Join us Wednesday, May 22nd at 6:00pm in the ballroom to get more information and try on bathing suits
T-Shirts $20.00 :*	No T-Shirt Youth Small Youth Medium Youth Large Adult Small Adult Medium

Vesper Country Club
185 Pawtucket Blvd
Tyngsboro, MA 01879