NAME ADDRESS ZIP CityParks PHONE EMAIL AGE Seniors NEW PARTICIPANT? Y N • WALKING • YOGA PART ICIPANT AGREEMENT FitnessTENNIS 1) I verify that I have consulted with my doctor and have permission to participate in CityParks Seniors Fitness, September 22 - October 31, 2014 admin istered by City Parks Foundation (CPF). I understand and assume the risk incidental to any of the activities I will participate in, and I release, and agree to hold harmless CPF, The City of New York / Parks & Recreation and any other sponsors and the parents, subsidiaries, agents, officers, and employees thereof from any and all liabilities resulting from such causes. 2) During the time of my participation, I hereby grant CPF, its employees, and its agencies full authority to take whatever actions they consider to be warranted for the protection of my health and safety. In addition, I also hereby release each of them from any liability from any such decision and actions taken by them forthwith. The authority shall include the right to obtain, and without further consent, appropriate medical services and treatment. PRESENTED BY 3) I grant CPF, the City of New York / Parks & Recreation and its subsidiaries, the right to videotape, film, and photograph me, and the right, in perpetuity, to use my FREE name, likeness, biographical­­ information and voice in all forms of media (including the internet) in connection with SUPPORTED BY LESSONS Zwicker Electric; New York City for adults ages 60+ the advertising and promotion of CPF and/or the City Council under the leadership of Melissa Mark-Viverito; Manhattan PROMOTING HEALTHY of New York / Parks & Recreation. LIFESTYLES IN NYC PARKS Delegation of the NYC Council; NYC Council Member Julissa SIGNED Ferreras; NYC Council Member Ben Kallos; NYC Council Member Helen Rosenthal; NYC Council Member Annabel Palma; NYC DATE FALL 2014 Olmsted Center Flushing Meadows Park, NY 11368 City Parks Foundation Parks City Council Member Laurie Cumbo. IN COOPERATION WITH # Have TO REGISTER All activities are FREE and include free use of equipment. Activities take place twice a week for one hour. Participants are encouraged to register for multiple activities, if available, and to maintain regular attendance. Class sizes for yoga are limited and open on a first-come basis. PLEASE CHECK the park and activities that you would like to fungetting fit! participate in: BRONX BROOKLYN Pelham Bay Park Marine Park Middletown Road & Stadium Ave p TENNIS T/Th 11AM p YOGA T/Th 9AM Tennis Courts Ave S & E. 32 St 6-week p YOGA M/W 9AM Soundview Park Nature Center Ave U & E. 32 St season Lafayette Ave bet. Boynton and Colgate South Oxford Park begins p WALKING M/W 9AM S. Oxford St & Atlantic Ave September 22nd p YOGA M/W 10AM p YOGA M/W 11AM Van Cortlandt Park STATEN ISLAND Woodlawn Tennis Courts Tennis Lessons Jerome Ave & E. 233 St Greenbelt Park p WALKING T/Th 9AM Brielle Ave bet Rockland & Wolcott Learn a new activity p YOGA M/W 9AM p TENNIS M/W 10AM (2hrs) Fitness Walks and make new p YOGA T/F 9AM MANHATTAN friends in your Yoga Instruction QUEENS neighborhood park. Carl Schurz Park QUEENS Astoria Park • Cunningham Park E. 86 St & East End Ave Astoria Park Flushing Meadows Corona Park • Roy Wilkins Park p WALKING M/W 9AM Tennis Courts p YOGA T/Th 9AM 21 St & Hoyt Ave S xercise, even in moderate amounts, can help Pelham Bay Park • Soundview Park BRONX p TENNIS M/W 10AM (2hrs) us feel and look better, maintain or lose weight, Van Cortlandt Park Central Park E Tennis Courts Cunningham Park reduce our risk for heart disease and diabetes, MANHATTAN Carl Schurz Park 93rd St. near West Drive Tennis Courts p TENNIS F 1PM (2hrs) Union Turnpike & 193 St and minimize the symptoms of arthritis. Central Park • Inwood Hill Park • John Jay Park p TENNIS T/Th 9AM Inwood Hill Park If you are age 60 or over, CityParks BROOKLYN Tennis Courts p YOGA T/Th 10AM Seniors Fitness provides a fun, FREE way Marine Park • South Oxford Park 207 St and Seaman Ave Flushing Meadows this fall to get started ... and keep active. STATEN ISLAND Greenbelt Park p TENNIS T/Th 10AM Corona Park p YOGA M/W 11AM Tennis Courts Meridian Rd John Jay Park p TENNIS M/W 10AM (2hrs) To register, complete the E. 77 St & Cherokee Place Roy Wilkins Park See you attached application and mail to: p YOGA T/Th 10:30AM Tennis Courts on the City Parks Foundation Baisley Blvd & 177 St first day Seniors Fitness, Olmsted Center p TENNIS T/Th 10AM of class! Flushing Meadows Park, NY 11368 p YOGA T/Th 9AM SIGNATURE SPONSOR Please complete this application and read and sign For information, call (718) 760-6999 or visit www.CityParksFoundation.org PARTICIPANT AGREEMENT on back. .