Newton Indoor Sports Center

 

April Vacation Week Camp

April 17th20th , 2007

 

Instructors: David Wainwright

 

·      Ages:  7 – 15 years (Co-ed)

·      Times:  Drop Off 8:30 – 9:00am,        Pick Up 3:30 – 4:00 pm

·      Days:   Tue. - Fri.

·    Price: $50.00 per day / $160 for 4 days

·    Dates: April  17th,  18th,  19th , 20th

 

 

All children must bring a bag lunch. ***No refrigeration available.

 

………………………………….Application………………………………………

 

Child’s Name_______________________________________________ Age/DOB___________________

 

Parent/Guardian_________________________________________________________________________

 

Address_______________________________________________________________________________

 

City______________________________________________ State_______________ Zip______________

 

Home Phone # _________________________________ Work Phone # ____________________________

 

Emergency Contact ____________________________________ Phone # __________________________

 

 

Circle Date(s) Registering for:   Tues. 4/17/07  |  Weds. 4/18//07   |  Thurs. 4/19/07   |  Fri. 4/20/07   Amount enclosed__________

 

 

Hold Harmless Release Form

I, the parent/guardian of the above applicant, hereby assume all risk and hazards incidental to participation in any and all league/clinic activities during the current season. I hereby waive, release, absolve, indemnify, and agree to hold harmless the organizers, sponsors, supervisors, participants, and corporation owners of the premises for any claim arising out of injury to my child.

 

Parents’ Signature_____________________________________________ Date____________________

 

***Full Payment Required for Registration. Please make checks payable to: Newton Indoor Sports Center. Please mail payment with application to 125 Wells Ave., Newton MA 02459

 

 

Newton Indoor Sports Center 125 Wells Ave., Newton MA 02459 (617) 964-0400