2020 Sea Serpent Registration - Non-Member

Child 1 Information
Child 2 Information
Child 3 Information
Parent/Guardian 1
Parent/Guardian 2
Other Contacts
Medical Information

WAIVER AND RELEASE OF LIABILITY FOR MINORS – In consideration for permission to participate in any activity at Scott Valley Swimming & Tennis Club, specifically including but not limited to camps, lessons, special events and general use of the facilities, today and on all future dates, I, for myself, and on behalf of the minor child/children identified above, our heirs, personal representatives and/or assigns, do hereby release, waive, discharge, and covenant not to sue Scott Valley Swimming & Tennis Club, its directors, officers, owners, employees or agents (collectively referred to herein as the “Club”), from liability for any and all claims for personal injury, illness, death, property damage, or any other claim, including but not limited to claims arising out of the negligence of the Club, its employees or its agents. This waiver and release of liability applies to all Club activities, without limitation, regardless of whether participation requires the Participant to leave the Scott Valley Swimming & Tennis Club premises and regardless of whether a separate fee was charged for the activity.

After you hit the submit button, please follow the new link to payment. You will first be required to create an account in the Club's Paycloud Portal where you have the option to pay either through your own bank (ACH) or via credit card. You can execute the ACH payment from within this Portal. If you choose to pay by credit card, you will be taken to the credit card processing provider, Plastiq, where you will need to create your unique account, and please note processing fees will apply. Please do keep a record of your login credentials so you will be able to quickly pay for future swim sessions.

* Denotes Required Field