Coronavirus (COVID-19) Information & Updates Read Here

Membership Application

Apply for membership at one of our Neighborhood Programs

  • MM slash DD slash YYYY
  • Emergency Contact Information

  • Medical Information

    *As with any exercise program, we recommend consulting with your physician prior to participating.

  • Neighborhood Program Liability Waiver

  • have been informed of and agree to participate in Neighborhood Outreach Programs including Wellness Programs (collectively, the “Programs”), organized by Episcopal SeniorLife Communities (“ESLC”). In exchange for my participation in the Programs, I agree to the following:

    I agree to obey and observe any and all posted warnings and rules, and agree to follow any directions or oral instructions given by ESLC, or the employees, representatives, affiliates, or agents of ESLC.

    I understand that my time spent at ESLC and any of its affiliated sites may include various activities that may be hazardous to my health. I hereby expressly and specifically assume the risk of injury or harm in these activities and release ESLC, its partners, affiliates, employees, representatives, and agents from any and all liability for injury, illness, loss, death, or property resulting from my activities of my use and presence upon the facilities whether caused by fault of myself, ESLC and its affiliates, or a third party. I understand that I am participating in these activities at my own risk.

    I, on behalf of myself and my heirs, executors and administrators, agree to release, indemnify and hold harmless ESLC, its partners, affiliates, and its representative officers, employees, agents, and directors from any and all liability and claims, demands, losses, causes of action, lawsuits, damage, judgments, including attorneys’ fees and costs, arising out of my participation in the Programs, my use of and presence at ESLC and any of its affiliated sites and partner sites, or any disclosure of my authorized personal information.

    In the event of damages, I agree to pay for any and all damages caused by my presence at ESLC, or at an affiliated site. Any equitable or legal claim or claims that may arise from my participation in the above activity shall be resolved under the laws of New York State.


  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

Contact us today

  • This field is for validation purposes and should be left unchanged.
Search Careers >

Want tips & resources to learn more about senior living?

Follow Our Blog

Find What You Need!

Select the level of care you need below to see our communities near you.

Looking for A Career?

© Episcopal SeniorLife Communities 2022

Privacy Policy | Site Map Equal housing opportunity and handicap icon

Content by Sally Dixon Concepts & Copy

Photography by

Facebook Instagram Twitter Linkedin
Contact Us Today
  • This field is for validation purposes and should be left unchanged.