Click To Print This Page And Return

A SEPARATE FORM MUST BE SUBMITTED FOR EACH CLASS

CUT ALONG DOTTED LINE AND RETURN REGISTRATION FORM TO ENROLL IN CLASSES TO THE SPRING GROVE AREA COMMUNITY CENTER AT 50 NORTH EAST STREET, SUITE 1, SPRING GROVE, PA 17362 - Make checks payable to Spring Grove Regional Parks & Recreation Commission or "SGRPRC"


 

Spring Grove Regional Parks & Recreation Commission

Spring/Summer 2007 Course Registration

Name ____________________________  Course Title ______________________________

Address __________________________________________________________________________

_____________________________     Borough/Township Residing ____________________

Home Phone ____________________   Work Phone ________________________________

 I fully understand and accept the risks involved in participating in any strenuous activity and I absolve the Spring Grove Regional Parks & Recreation Commission, Spring Grove Area Community Center and Spring Grove Borough from all liability for any personal injury incurred through my participation in any Spring Grove Regional Parks & Recreation Commission and/or Spring Grove Area Community Center sponsored education, exercise, and/or physical activity program.

 Signature ______________________________________   Date ____________________

 Signature of parent or guardian _____________________________________________________

(only if registrant is under 18 years of age)