Elmsford, NY · Westchester County
Senior Registration Form
Elmsford seniors use this form to register for a Village program and provide contact, emergency, and health information.
What this form is
The Village of Elmsford Senior Registration Form collects a senior's contact details, date of birth, living arrangement, gender, two emergency contacts, and information about medical conditions or medication. The form says this information must be completed before participation in the program. It also includes a waiver releasing the Village and its employees and agents from liability for damages or injuries connected with participation.
Who needs it
Seniors who plan to participate in a Village of Elmsford program need to complete the requested information before participating.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the registrant signs and dates the waiver.
How to submit this form
- 1
Download The Form
Download the Senior Registration Form from the Village of Elmsford.
- 2
Complete The Form
Print clearly and provide the requested personal, contact, emergency contact, and health information.
- 3
Sign And Date
Sign and date the waiver included on the form.
- 4
Submit To The City
Submit the completed form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Senior Registration Form?
- No. The form has no notary block; the registrant signs and dates the waiver.
- How do I submit the Senior Registration Form?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
- What information does the form ask for?
- It asks for contact details, date of birth, living arrangement, gender, two emergency contacts, and information about medical conditions or medication.
- When must the form be completed?
- The form states that the requested information must be completed before participation in the Village program.
Need something notarized?
This Senior Registration Form doesn’t need a notary — but if you have another Elmsford form that does, a commissioned online notary can help.