search.noResults

search.searching

note.createNoteMessage

search.noResults

search.searching

orderForm.title

orderForm.productCode
orderForm.description
orderForm.quantity
orderForm.itemPrice
orderForm.price
orderForm.totalPrice
orderForm.deliveryDetails.billingAddress
orderForm.deliveryDetails.deliveryAddress
orderForm.noItems
REGISTRATION FORM MAIL-IN OR DROP OFF FORM AT:


Lisle Park District, 1925 Ohio Street, Lisle, IL 60532 Attn: Mail-in Registration


PLEASE PRINT 


Last Name............................................................................................................ First Name.................................................................. Date............/.............../.................... Street Address............................................................................................................................................................. City................................................. Zip........................... Home Phone (.................) ...................-......................... Work Phone (.................) ...................-......................... Cell Phone (.................) ...................-......................... Birthdate (mm/dd/yyyy) .........../.........../.................. Email Address .................................................................... Add me to the e-newsletter list o Yes o No


ACTIVITY NAME FEE REGISTRANT’S FIRST NAME GRADE SEX BIRTHDATE (MM/DD/YYYY)


There will be a $25 service charge assessed for all checks / credit cards returned for non-sufficient funds.


You can fax in your registration to the Lisle Recreation Center at 630-964-7448 by credit card (VISA, Mastercard, Discover) only. You must follow registration procedures found on page 4.


This section must be filled out if you are using VISA, MasterCard or Discover. Cardholder Name .............................................................................................................................. Account Number ........................................................................................ CVC Code .................. Expiration Date ............/............... Amount Charged $.................................................................. Authorized Signature ........................................................................................................................


Office Use Only


Location # ........................................................................................................................ Total Received ................................................................................................................. Paid By: o D o M o V o C o K o S Initials: .........................


Do participant(s) require assistance or accommodations to participate in any programs? o Yes o No If yes, please explain: ____________________________________________________________________________________________________________________________


_______________________________________________________________________________________________________________________________________________


WARNING OF RISK: Recreational activities/programs are intended to challenge and engage the physical, mental, and emotional resources of each participant. Despite careful and proper preparation, instruction, medical advice, conditioning, and equipment, there is still a risk of serious injury when participating in any recreational activity/program. Understandably, not all hazards and dangers can be foreseen. Depending on the particular activity, participants must understand that certain risks, dangers, and injuries due to inclement weather, slipping, falling, poor skill level, conditioning, careless- ness, horseplay, unsportsmanlike conduct, premises defects, inadequate or defective equipment, inadequate supervision, instruction, or officiating, and all other circumstances inherent to indoor and outdoor recreational activities/programs exist. In this regard, it must be recognized that it is impossible for the Lisle Park District to guarantee absolute safety.


WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK: Please read this form carefully and be aware that in signing up and partici- pating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages, or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/


activity (including transportation services/vehicle operation, when provided).


I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or that may accrue to me or my child/ward) as a result of participating in this program/activity against the Lisle Park District, including its officers, officials, agents, volunteers and employees, and the Village of Lisle, including its officers, officials, agents, volunteers and employees (hereinafter collectively referred as “Parties”).


I do hereby fully release and forever discharge the Parties from any and all claims for injuries, damages, or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with this program/activity.


PHOTOGRAPHS: Photographs and videos are taken of participants to use for promotional purposes. By registering for a program, you have granted us permission to use your image for promotional purposes unless otherwise stated.


I have read and fully understand the above important information, warning of risk, assumption of risk, and waiver and release of all claims. If registering online or via fax, your online or facsimile signature shall substitute for and have the same legal effect as an original form signature.


Participant’s Signature....................................................................................................................................................... Date............/.............../.............. (18 years or older or Parent/Guardian)


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80