FYI: Non-residents may register for Park
District programs at a slightly higher fee. For those who choose, a
"Non-Resident Family Card" is available for purchase which allows family
members to receive a resident rate for one year. This card can be
purchased at any time for $125.00.
Are you a Non-Resident Cardholder? Yes
No
Date Card Issued ______________________________
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Program # |
Program/Trip
Name |
Participant's
Name
Complete information is needed
below for each person when different from address and phone given above. |
Birth
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| Please note: T-shirt size,
golf clubs needed, special needs:
__________________________________________________ |
WITHOUT PROPER SIGNATURE THIS FORM WILL NOT BE PROCESSED
WAIVER AND RELEASE OF ALL CLAIMS: As a participant in the above program(s),
those listed above recognize and acknowledge that there are certain risks of
physical injury and those listed above agree to assume the full risk of any
injuries, including death, damages or loss which those listed above sustain as a
result of participation in any and all activities connected with or associated
with such programs. Those listed above agree to waive and relinquish all
claims those listed above may have as a result of participation in the program(s),
against the Sandwich Park District, its officers, agents, servants and
employees. Those listed above hereby fully release and discharge the
Sandwich Park District and its officers, agents, servants and employees from any
and all claims from injuries, including death, damage or loss which may accrue
to those listed above on account of participation in the program(s). Those
listed above further agree to indemnify and hold harmless and defend the
Sandwich Park District and its officers, agents, servants and employees from any
and all claims resulting from injuries, including death, damages and losses
sustained by those listed above arising out of, connected with, or in any way
associated with the activities of the program(s). I have read the above
recreation waiver and release of all claims, and understand that my signature is
required below in order to participate in; any Sandwich Park District programs.
Signature is required of all participants 18 years or older and of
parent/guardian for those participants under 18 years of age.
________________________________________________________________________________ _______________
Participant's Signature - Note: a parent/guardian must sign for above listed
participants if they are under the age of
18. Date