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2012.06.13 Parks Packet
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2012.06.13 Parks Packet
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6/23/2016 9:06:48 AM
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6/23/2016 8:58:45 AM
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Commissions
Meeting Date
6/13/2012
Document Type
Agenda/Packets
Commission Name
Parks
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,0. <br />www.skyhawks.win <br />Participant Last Name <br />Participant First Name <br />Parent Last Name <br />Email <br />Mailing Address <br />City <br />Home Phone ( <br />Emergency Contac _ <br />Course # <br />Registration Form <br />4 WAYS TO REGISTER <br />MAIL <br />City of Hugo - Parks and Recreation <br />14669 Fitzgerald Avenue North <br />Hugo, MN 55038 <br />Make Checks Payable to: <br />City of Hugo <br />Hugo City Hall <br />14669 Fitzgerald Ave. N. <br />Hugo, MN <br />For more information please call City of Hugo: 651-762-6300 or Skyhawks: (866) 849-9936 <br />FAX <br />(888)466-2318 <br />Service fee per child <br />program will be <br />;essed for faxed <br />Birth Date_ _ Age_ Gender: M / F <br />Parent First Name <br />State <br />Cell Phone ( ) <br />Phone <br />Zip <br />PLEASE LIST THE PROGRAM(S) YOUR CHILD WILL ATTEND. Photocopy for additional children. <br />Sport <br />Date <br />Location <br />Fee <br />Parents, please read and sign the Medical Consent and Release of Liability below to complete registration. <br />I, the undersigned parent/guardian of the participant, understand this activity involves an element of risk and a danger of accidents and <br />injury and knowing those risks I hereby assume those risks. I authorize the program providers as Agents for the undersigned to consent <br />to medical, surgical and/or dental examination, in addition to any and all other treatments deemed necessary by medical personnel. I <br />understand by signing this agreement, I knowingly release and discharge Skyhawks and City of Hugo from any and all liability resulting <br />from any injury associated with the participant's participation in this activity. I agree that pictures taken during program hours may be used <br />for promotional purposes and that I give my permission to Skyhawks and City of Hugo to use any images of the participant without <br />compensation. Skyhawks will not provide health and/or accident insurance for program participants. By signing below, I attest that I <br />have read and fully understand and agree to the assumption of risk, waiver and release of all claims, and the photo policies set forth <br />herein. <br />Signature Print <br />"This is our 2nd year and we would definitely do this program again and <br />recommend it to friends!! It was once again a great experience!!!" <br />Amy F. <br />
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