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St. Lawrence College Employee SHAC Membership Form

St. Lawrence College recommends that you consult with your physician before participating in any SHAC or YMCA program, and/or using any SHAC/YMCA fitness equipment or facilities. Neither the SHAC/YMCA, its staff, its instructors, nor its volunteers are licensed medical care providers and have expertise in determining the effect of any specific program, such as an exercise program, or use of equipment, on a medical condition.

The St. Lawrence College employee membership does NOT include access to any YMCA location. It only allows access to the SHAC on the Kingston campus.

The cost for the SHAC Staff pass is $35/month and is automatically deducted from your payroll. Contracted staff (i.e. C&W Services, contractors) can sign up for a pass. Payment is made at student services for those not on College payroll.

There is no need to pick up a STAFF PASS Sticker. By completing this form, your name has been added to the list of staff that can access the SHAC.

If at any point you need to cancel your SHAC staff membership, please email Kevin Biggs (kbiggs@sl.on.ca).

Member Information

Please complete all sections for membership information.

First and Last name *

Employee Number *

(7-digit number, not shared with YMCA)

Department *

Street Address *

City *

Province *

Postal Code *

(A1A 1A1)

Phone number *

Email Address *

Emergency Contact Name and Phone Number *

St. Lawrence College Employee SHAC Membership Form

St. Lawrence College Employee SHAC Membership Form

Member Information

Payment

Waiver

Signature