4/25/2009 - YOUTH ROLLER HOCKEY EVENT

YOUTH ROLLER HOCKEY

SPONSORED BY:

ROSELLE PARK RECREATION COMMITTEE

SATURDAY, APRIL 25, 2009

(THERE IS NO RAIN DATE)

9-12 YRS OLD 10:00AM- 11:OOAM

13-18 YRS OLD 11:00AM-1:00PM

RINK LOCATION: COMMUTER PARKING LOT

(BEHIND D.P.W. - WEST WEBSTER AVENUE)

(MORE INFO - CALL - 241-0564)

ALL PARTICIPANTS MUST SUPPLY THEIR OWN EQUIPMENT. ALL PARTICIPANTS MUST WEAR PROTECTIVE GEAR (HELMETS KNEE PADS,PROTECTIVE PADDING, MOUTH PIECES, ETC)
NAME____________________________________ DATE ________________

ADDRESS____________________________ PHONE (908) _______________

BlRTHDATE _______________AGE____ GRADE____ MALE __ FEMALE ___

 

It is understood and agreed that the Recreation Department or Board of Education shall not be liable for anydamages arising from personal injuries sustained by the participants in, on or about the premises, resulting from or arising out of the use or intended use of the facilities and equipment of the Schools or Recreation Department, and employees of the Recreation Department or School Facilities or the negligence of any other person on said premises, or injury involved in connection with traveling to, entry in, and returning from any programs. Participate at your own risk

There is no voluntary medical reimbursement for recreation activities.

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SIGNATURE OF PARENT/GUARDIAN                           DATE______________


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SIGNATURE OF PARTICIPANT