b'Register online or use the form!Please write in the activities you are participating in: REGISTRATION INFORMATIONList Class Name Session/Date Cost 1. Preregistration is neces-__________________________________________________________________________ sary for all programs un-less otherwise stated.___________________________________________________________________________ 2. Registration will be taken on a first come, first paid ___________________________________________________________________________ basis.(you are not limited to the space above feel free to use an additional sheet of paper for others) 3. Register online, mail in registration or come by Participant Name ___________________________________________ Grade ____________ the HRC office.Adult Male_____ Female _____ Age _____ Date of Birth : _____________ T-Shirt size _________ team sport entries must pick up a registration Home#: __________________Work#: __________________ Cell#: __________________ packet at the HRC office.Address/City ________________________________________________________________4. No phone-in, e-mail or faxed registrations will be Family E-mail: _______________________________________________________________ accepted.5. Payment must accompany List any medical conditions or food allergies if any ___________________________________ registration.Emergency Contact:Please list someone (other than Parent/Legal Guardian if participant is6. Late registration will only under 18) who can be contacted in case of emergency. be accepted to fill remain-ing vacancies in pro-Name __________________________________________Relation: ____________________ grams.Late fees will be assessed for late registra-Home#: __________________Work#: __________________ Cell#: __________________ tion.IF PARTICIPANT IS UNDER THE AGE OF 18: 7. Waiting lists will be formed for all entries Mothers Name: ____________________ Address if different: _________________________ once programs are full.Home#: __________________Work#: __________________ Cell#: __________________ 8. Consolidation of differ-ent sessions of activities Fathers Name: ____________________ Address if different: _________________________ may be necessary due to enrollment.Home#: __________________Work#: __________________ Cell#: __________________ 9. The HRC reserves the right to cancel, restruc-The undersigned, understands that injuries are a natural part of many recreation activities and agrees toture or consolidate any indemnify, hold harmless and release the Hays Recreation Commission (HRC) their agents and employeesactivity if conditions war-from any and all liability for any injury which may be suffered by the above named individual(s) registeredrant.in this activity arising out of or in any way connected with participation in this activity. The undersigned10. Due to a lack of supervi-and participant authorize the HRC to use at its discretion any photograph(s) or video taken of thesion, unless an activity is participant while participating in any activity and waive any and all claims that the participant or thedesigned to supply child undersigned or their heirs, executors, administrators, or assigns may have or claim to have resulting fromsupervision; no children such photograph(s) or reproductions thereof. I have read the above statement, understand and agree towill be allowed to attend the conditions set forth.I agree to abide by all policies and guidelines set forth by the HRC regarding thisadult only activities.program. 11. Fee assistance for youth Signature ________________________________________________ Date ______________ HRC programs is availableParticipant (must be over 18) Parent/guardian (for all participants under 18) through the Youth Schol-arship Program.785-623-2650 - www.haysrec.org - firstname.lastname@example.org 63'