Please join the SRC so that you can participate in our activities.
You must register for the Senior Recreation Council each year to remain a member.
- You can print the form below (scroll down) and fill it out in ink.
- We need to have a signed waiver on file for each participant, which means we need to have a form filled out for each participant. Please print legibly.
- Identification of an Emergency Contact and an Emergency Daytime Telephone Number ensures we can notify whoever you want in case of an emergency. Mishaps occur infrequently, but they do occur, and on those occasions we may need emergency contact information quickly.
- We do not share e-mail addresses with anyone outside of SRC.
- IMPORTANT: Please circle all Senior Recreation Council activities in which you are currently participating or intend to participate during 2025. This lets us inform those activity coordinator(s) of your interest. You will receive information you need and the activity coordinator will know that you are registered when you come to an activity.
- If any of the information changes during the year please let us know about those changes as soon as possible by contacting Susan Janssen at 301-695-1785.
Your signature acknowledging waiver of liability, is required!
Don’t forget to include $10 for yearly dues.
Upon completion of the form, please enclose it in an envelope with your check to:
Ms. Susan Janssen
2273 Wetherburne Way
Frederick, MD 21702-3108