2017 Summer Recreation Registration

2 0 1 7 S U M M E R R E C R E A T I O N R E G I S T R A T I O N

Child’s Name ______Age ______

Current Grade ______Do you use Facebook? (Search Minneota Summer Rec and click like for updates)

Address ______

Emergency Contact Name ______Phone # ______

Parent Names______

Email Address ______

ANY SPECIAL NEEDS: (Medical, disabilities, allergies) that we should be aware of:

______

Softball

Softball (10 & under – Peanut: Finishing 2nd - 4th grade) $50.00 or ($45.00 finishing 2nd grade only)

Softball (12 & under - PeeWee: Finishing 5th & 6th grade) $50.00

Softball (14 & under - Midget: Finishing 7th & 8th grade) $50.00

 P l e a s e f i l l o u t s i z i n g i n f o r m a t i o n o n t h e b a c k s i d e

S o f t b a l l U n i f o r m  N e w d r i f i t s h i r t t h i s y e a r . E v e r y t h i n g e l s e i s t h e s a m e .  2 n d - 8 t h g r a d e m u s t o r d e r n e w d r i f i t s h i r t t h i s s e a s o n .  A l l p l a y e r s w i l l n e e d a s h i r t , p a n t s , a n d b e l t .  H a t s w i l l b e a d j u s t a b l e i n s i z e a n d a r e o p t i o n a l .

S h i r t $ 1 0 G r a y P a n t s $ 1 0 H a t $ 1 3 B e l t $ 4

S h i r t P a n t s C h i l d – X - S m a l l C h i l d – S m a l l C h i l d – S m a l l C h i l d – M e d i u m C h i l d - M e d i u m C h i l d - L a r g e C h i l d - L a r g e C h i l d – X - L a r g e C h i l d – X - L a r g e A d u l t - S m a l l A d u l t - S m a l l A d u l t - M e d i u m A d u l t – M e d i u m A d u l t – L a r g e A d u l t – L a r g e A d u l t – X - L a r g e A d u l t – X - L a r g e A d u l t – X X - L a r g e A d u l t – X X - L a r g e

Total Fee:______

I hereby waive and release any claim I may now or hereafter have against the City of Minneota, its officers, employees, volunteers or assigns, for personal injury or property damage incurred by me, while participating in City sponsored Summer/Community Recreation events. I hereby expressly assume all risks incident to participating in Summer/Community Recreation, including, but not limited to any risk of personal injury or property damage wherever that injury or damage may occur. I hereby agree to indemnify and hold harmless the City of Minneota, its officers, employees, and volunteers for all damages or losses I may incur as a participant in Summer/Community Recreation events.

______Parent / Guardian Signature Date