ELC Outside Service Provider Information Form

I acknowledge that I am not an employee, agent, or representative of the Suffolk Y JCC. My presence within the facility is solely for the purpose of accompanying a participant to their program or to assist the participant to use the SYJCC facility that the participant is entitled per their membership. I understand that I DO NOT have an active membership. I understand that this access does not imply any employment relationship or entitlement to employee benefits, responsibilities, or privilege. I also acknowledge that I must have my agency ID as well as the SYJCC ID on me at all times while in the building.