Children Age 4 to 13 by June 15th, 2020

Playgrounds start Monday, June 15th and ends Thursday, August 6th. Children must be 4 years old by June 15th, 2020 and fully potty trained to participate in the playground program.
Playgrounds program is

Child's First Name: Child's Last Name: Phone Number: Age as of June 15th, 2020: Parent/Guardian Name: E-mail: Allergies: T-shirt(Optional)-- Additional $8 USD Special Requests?(Letters only)

Park Options: Stuart McBride Park Ages 4-8: AM Session 8:45am-11:30am Stuart McBride Mom + Tots Program(Ages 2-3): 1pm-2:30pm Drozd Park Ages 4-8: AM Session 8:45am-11:30am Drozd Park Ages 8-13: PM Session 12:45pm-3:30pm Smolenski Park Ages 8-13: AM Session 8:45am-11:30am Smolenski Park Ages 4-8: PM Session 12:45pm-3:30pm

Address:(Please include city and zip code)

Fees: No refunds. Sales tax included if applicable Resident of Mt. Pleasant: $85 + $2.50 Electronic Transaction Fee= ($87.50 USD) Non-Resident of Mt. Pleasant: $100 + $2.50 Electronic Transaction Fee= ($102.50 USD)

Important Information :
The Village of Mount Pleasant is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard. The Village continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participants’ safety. However, participants and parents/ guardians of minors registering for this program/activity must recognize that there is an inherent risk of injury when choosing to participate in recreational activities/programs. You are solely responsible for determining if you or your minor child/ward are physically fit and/or adequately skilled for the activities contemplated by this agreement. It is always advisable, especially if the participant is pregnant, disabled in any way or has recently suffered an illness, injury or impairment, to consult a physician before undertaking any physical activity.

Warning of Risk :
Recreational activities 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. All hazards and dangers cannot be foreseen. Depending on the particular activity, certain risks, dangers and injuries may exist due to inclement weather, slips and falls, poor skill level or conditioning, carelessness, horseplay, unsportsmanlike conduct, premises defects, inadequate or defective equipment, inadequate supervision, instruction or officiating, and other risks inherent to the particular activity. In this regard, it is impossible for the Village to guarantee absolute safety.

Photo/Video Policy :
The Village takes photos and video of participants in classes, during special events and in the parks. By signing the waiver, you are giving permission to the Village to use these photos and video in Village publications and on the Village website and social media outlets. All photos and video are the property of the Village.

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Parent or Guardian Signature:

Date: Saturday, 30 May 2020 (EDT)

Name:

Type your name to sign this document:

Typing name is equivalent to a handwritten signature

Notice: Parents will be contacted via e-mail a week before start date with details for the summer.

Please contact bbodnar@mtpleasantwi.gov with any questions!