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.
Child’s Name_______________________________________________ Age/DOB___________________
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__________
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