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Club Fit Jefferson Valley Summer Camp Registration Form

Club Fit | Club Fit Jefferson Valley Summer Camp Registration Form

Club Fit Jefferson Valley Summer Camp Registration Form

Camp Director: Mary Ann Helf | 914.250.7725 |

Please remember to press the send button at the end so we receive your registration request. Our Camp Director will contact you to confirm your request.

* Required Fields


Camp Selection*
Please Select your Desired Week(s) of Camp:*

Early Drop-off ($10 per day)*

Participant is a*

Apply Sibling Discount?*

Emergency Contact info (someone other than parent/guardian; also authorized to pick up)

Payment Info*

Medical Info

Terms and Conditions*


Swimming is one of the optional daily activities available to children 4+ enrolled in Club Fit Summer Day Camp. Swimming will take place at the Club Fit Jefferson Valley facility during designated group swim times. Campers are supervised by lifeguard staff on site, a designated camp lifeguard, and the Club Fit Summer Camp Staff. Group ratios, supervision, and buddy checks are conducted in accordance with Westchester County Board of Health camp safety requirements. Each participant can be swim tested by a Certified American Red Cross Water Safety Instructor if requested and depending upon the results categorized as a swimmer or non-swimmer. If no test is given

the camper is considered a non-swimmer. To be qualified as a swimmer the participant must complete the following:

Component one* (administered in water less than chest deep of the camper) 

* Testing to be administered in Program Pool

• Feet first entry into chest deep water • Swim front crawl for 25 yards • Shows the ability to follow the instructions

Component two* (administered in water greater than chest deep only after component one is successfully completed)

* Testing to be administered in in Lap Pool

• Maintain position on back 1 minute • Tread water for 1 minute • Swim back crawl for 25 yards

We take safety seriously. Students will be expected to follow the pool rules and Club Fit Camp safety rules at all times. These rules will be presented at the start of each swim period daily.


Summer day camp shall allow children attending to carry and use insect repellent and sunscreen with the written permission of a parent or guardian. A child who is unable to physically apply insect repellent or sunscreen may be assisted by unlicensed personnel when directed to do so by the child with written permission by parent or guardian. I give Club Fit camp personnel permission to apply insect repellent and/or sunscreen on my child.


I represent that I/my child am/is in good physical condition and have no condition preventing me/us from safely participating in the Club’s fitness, sport, and wellness programs. To the extent that my/their physical condition changes over time, I understand that it is our responsibility to monitor my/my child’s physical condition and the Club will not be responsible for any changes in my/their physical circumstances. I/my child appreciate the risks associated with physical activity and the potential for physical stress, strain and injury. I/we also appreciate that there is risk to using or storing personal property at the Club. Accordingly, I/we assume knowingly whatever risks may be involved by reason of my/our use of Club Fit and its facilities, equipment and services. Further, I/we hereby agree to release, indemnify and hold harmless Club Fit, its members, principals, directors, officers, shareholders, employees, affiliates, agents, servants and representatives (the “Indemnitees”) from and against any and all action, claim or suit for personal injury, death or loss, liability or damage to property, costs, expenses or liability, including reasonable attorneys’ fees (collectively referred to as “Loss”) in connection with my/our use of Club Fit, its facilities, equipment or services. I/we waive any and all claims against the Indemnitees for any personal injury or property damage or loss relating to, arising from or connected with my use of Club Fit, its facilities, equipment or services, unless resulting from the negligence of Club Fit. Policies for summer camp at Club Fit are more fully set forth on website, It is understood the camp plan and policies, including hours of operation and activities, are subject to reasonable change with prior notification. If I/we fail to abide by the Club’s policies and rules, or if I/we conduct myself/ourselves in a manner that the Club, in its sole discretion, determines is inappropriate, Club Fit may immediately terminate camp participation without refund for the full week in which I/we are terminated as well as any additional charges incurred through termination date.


I/my child hereby grant to Club Fit my/our consent and permission to use my/our photographs or other likenesses, entries, pictures, portraits, voices, testimonials, biographical information (in whole or in part), and/or statements made by me/us regarding the Club worldwide and in perpetuity for any and all purposes, including, but not limited to, advertising, trade and/or promotion on behalf of Club Fit, in any and all forms of media, now known or hereafter devised, including, but not limited to, print, TV, radio, electronic, cable, social media, or World Wide Web, without further limitation, restriction, compensation, notice, review, or approval. I/my child hereby release and discharge Club Fit from any claims and demands arising out of or in connection with such use(s), including but not limited to any and all claims for libel or invasion of privacy/publicity. This Agreement embodies the entire agreement between the parties with respect to the subject matter hereof and may only be changed by a written instrument signed by both parties. This release, waiver, and consent shall be binding upon me and my heirs, legal representatives and assigns.

*You must scroll through the entire terms box in order to accept the terms

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