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Choose From Our 4 EASY WAYS to Register!


ONLINE FAX-IN


MAIL-IN PHONE-IN


★ Begins April 24, 2012 at 8 am. ★ See detailed instructions on page 49. ★ Go to: www.anaheim.net/ezrecconnect ★ Mastercard, VISA, or Discover accepted.


★ Begins April 24, 2012 at 8 am. ★ Use form at bottom of this page. ★ Fax to: (714) 765-5223 ★ Mastercard, VISA, or Discover accepted.


★ Begins April 24, 2012 at 8 am. ★ Use form at bottom of this page. ★ Mail completed form to: Anaheim Community Services/Registration, 200 S. Anaheim Blvd., #433, Anaheim, CA 92805


★ Begins May 15, 2012 at 8 am. ★ Have Mastercard, VISA, or Discover ready. ★ Call: (714) 765-5191 during business hours, Monday - Friday, 8 am - 5 pm


REGISTRATION INFORMATION • SUMMER 2012 REFUND INFORMATION


Requests for should be made in writing and returned to our offices by one of the following methods:


MAIL: FAX: Attn: Refund,


200 S. Anaheim Blvd. #433, Anaheim, CA 92805 Attn: Refund to (714) 765-5223


EMAIL: Subject "Refund," to ezrecconnect@anaheim.net


Please note that CampVenture and Adult Sports Leagues have different refund policies. Please see individual program information for details. No refunds or exchanges on Pearson Park Amphitheatre Tickets.


Refund fees for RECREATION CLASSES (classes meet 3 or more times) are as follows:


• Request for refund made within 5 days or less before the first class meeting are subject to a 10% withdrawal fee.


• Requests for refund made 24 hours or less prior to the first class meeting are subject to a 15% withdrawal fee.


• Refunds will not be granted after the second class meeting. Refunds must be requested prior to the start of the second class meeting.


Refund fees for RECREATION WORKSHOPS (workshops meet 1-2 times) are as follows:


• Request for refund made within 5 days or less before the workshop begins are subject to a 10% withdrawal fee.


• Requests for refund made 24 hours or less prior to when the workshop begins are subject to a 15% withdrawal fee.


• Refunds will not be granted after the workshop begins. MAIL-IN & FAX-IN REGISTRATION FORM


Please print clearly and fill out completely. Use additional forms if necessary. Photocopies are accepted. Mail to: Anaheim Community Services/Registration, 200 S. Anaheim Blvd., #433, Anaheim, CA 92805


ADULT CONTACT INFORMATION (required) ___________________________________________________________


FIRST NAME


___________________________________________________________ STREET ADDRESS


____________________________________________________________ LAST NAME


______________________________ CITY


_______________________________________________________________________________________ EMAIL (optional)


PARTICIPANT INFORMATION PARTICIPANT'S FIRST AND LAST NAME


EXAMPLE:


*Participant's Login ID # (optional): ____________ ❑ ADULT (18+ years) ❑ CHILD (0-17 years)


Jane Doe 000001


*Participant's Login ID # (optional): ____________ ❑ ADULT (18+ years) ❑ CHILD (0-17 years)


*Participant's Login ID # (optional): ____________ ❑ ADULT (18+ years)


I would like to make a donation to Anaheim Community Foundation


❑ CHILD (0-17 years) √ AGE DATE OF BIRTH


3 8 02 27861 Guitar /


/ N/A / N/A / N/A


Please add a tax-deductible donation in the following amount to my registration fees so I can support the foundation's efforts to improve the quality of life in Anaheim.


FORM OF PAYMENT ❑ Check ❑ Money Order ❑ VISA ❑ Mastercard ❑ Discover


Make your check or money order payable to City of Anaheim


ACCOUNT # EXPIRES: ______ / _______ SIGNATURE (required) ___________________________________________________________________


* FAMILY PIN# and *PARTICIPANT LOGIN ID # - *Family PIN # is the number assigned to your household. It is not required for Mail-In or Fax-In registration, but will help us process your form in case the information you provide is illegible due to handwriting or fax distortion.*Participant's Login ID # is the permanent identification number we assign to each person in your household who has participated in our activities in the past. It is not required for Mail-In or Fax-In registration, but will help us process your form in case the information you provide is illegible due to handwriting or fax distortion.


TOTAL FEES =


$ $ /


$ $


/


_________________________ ZIP CODE


_________________________________ *FAMILY PIN# (optional)


5 DIGIT CLASS # CLASS NAME $ FEES 180


( (


_____________________________________ ) DAYTIME PHONE NUMBER


_____________________________________ ) EVENING PHONE NUMBER


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