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How to Register: <br />• 1. Fill out the registration form below. <br />2. Registrations must be received before dass begins. Programs are subject to cancellation in the event of <br />insufficient enrollment. <br />3. Payment is due at time of registration- cash or check. Coming Soon....Credit Card payment online! <br />4. Fax, drop off, or mail your registration form to: <br />City Hall <br />2077 W. Larpenteur <br />Falcon Heights, MN 55113 <br />Phone: 651-792-7616 <br />Fax:651-792-7610 <br />Waiver of Participant In consideration of your accepting my child's entry, I hereby for myself, my child, <br />my heirs, executors, and administrators, waiver and release any and all rights and claims for damages I or my <br />child have against the above park department and its representatives, successors and assigns for any and all <br />injuries suffered by myself or my child and any activity sponsored by these groups. <br />Parent or Guardian <br />Address <br />City & Zip Code <br />• Phone (1) Phone (2) <br />Email Address <br />Participant's Name Sex Age Program Name Fee <br />Total <br />Does the participant have any special needs? Yes No <br />Signature Date <br />www.a.faloon-height~s.mn.us <br />Falcon Heights Parks and Recreation Registration Form <br />Cash Check CC# VS MC <br />