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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"
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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) |