2013.04.10 Parks Packet - Laserfiche WebLink

Home

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