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9 Participant’s Name: ___________________________________ Gender: _________ Date of Birth: __________________ Address: ________________________________________ City: _______________________ Zip: _________________ Home Phone: ______________________ Work Phone: _____________________ Cell Phone: _____________ _______ Please make check payable to the City of Arden Hills Totals: _________________ Refund Policy: No refunds are made except when a class is cancelled or approval is given by the Arden Hills Parks and Recreation Department. Partial credit will be considered if cancellation is due to injury or serious illness. Refunds will be issued in the form of a credit voucher only and must be used within a year of issue date. The registrant will be assessed a $5.00 administrative fee for all refund/voucher requests. Cancellations initiated by Parks & Recreation will not be as- sessed the $5.00 fee. Waiver of Liability: I, the undersigned, or my child, in consideration of being permitted to participate in the activity, do hereby agree to hold harmless the City of Arden Hills and its employees and agents from any and all liability for personal injury which may result from participating in this activity. This waiver includes any injuries which may result from the conditions of the playing field and any improvements thereto. Tennessen Warning: The information requested on the registration form will be used to verify eligibility and determine staff, facility, and equipment needs. You/Your child’s name, age, grade level, address, telephone number, and health information will be provided to city staff, volunteers, the city attorney, insurer, and auditor. Although you are not legally required to disclose this information, failure to do so will prevent you/your child from participating in the program. Participant Signature: _____________________________________________________ Date: _______________ Print Participant Name: ____________________________________________________ Emergency Contact Name: ____________________________________________________ Phone Number: ____________________ City of Arden Hills ‐ ADULT REGISTRATION FORM ‐ 1245 W Highway 96, Arden Hills, MN 55112 Activity Name: _____________________ Activity Code: _______________________ Start Date: ___________ Fee: _________ Location: __________________________ Activity Name: _____________________ Activity Code: ______________________ Start Date: ____________ Fee: ________ Location: __________________________ Activity Name: _____________________ Activity Code: ______________________ Start Date: ____________ Fee: ________ Location: __________________________ Youth Shirt Sizes: (Leagues & Camps) YS (6/8) YM (10/12) YL (14/16) AS AM AL City of Arden Hills ‐ Youth REGISTRATION FORM ‐ 1245 W Highway 96, Arden Hills, MN 55112 Participant’s Name: ___________________________________ Gender: _________ Date of Birth: __________________ Address: ________________________________________ City: _______________________ Zip: _________________ Home Phone: ______________________ Work Phone: _____________________ Cell Phone: _____________ _______ School: _____________________ Email: _______________________________Grade in 2019-2020 School Year: _______ Please make check payable to the City of Arden Hills Totals: _________________ Refund Policy: No refunds are made except when a class is cancelled or approval is given by the Arden Hills Parks and Recreation Department. Partial credit will be considered if cancellation is due to injury or serious illness. Refunds will be issued in the form of a credit voucher only and must be used within a year of issue date. The registrant will be assessed a $5.00 administrative fee for all refund/voucher requests. Cancellations initiated by Parks & Recreation will not be as- sessed the $5.00 fee. Waiver of Liability: I, the undersigned, or my child, in consideration of being permitted to participate in the activity, do hereby agree to hold harmless the City of Arden Hills and its employees and agents from any and all liability for personal injury which may result from participating in this activity. This waiver includes any injuries which may result from the conditions of the playing field and any improvements thereto. Tennessen Warning: The information requested on the registration form will be used to verify eligibility and determine staff, facility, and equipment needs. You/Your child’s name, age, grade level, address, telephone number, and health information will be provided to city staff, volunteers, the city attorney, insurer, and auditor. Although you are not legally required to disclose this information, failure to do so will prevent you/your child from participating in the program. Parent/Guardian Signature: _____________________________________________________ Date: _______________ Print Parent/Guardian Name: ____________________________________________________ Special Requests: __________________________________________________________________________________ Please Help Coach! If you sign up to coach (for sport leagues, not classes) your child’s sport registration is free. (One child per team coached.) I will help coach. Sport_______________________ Name_______________________________________ Phone#________________________ Activity Name: _____________________ Activity Code: _______________________ Start Date: ___________ Fee: _________ Location: __________________________ Activity Name: _____________________ Activity Code: ______________________ Start Date: ____________ Fee: ________ Location: __________________________ Activity Name: _____________________ Activity Code: ______________________ Start Date: ____________ Fee: ________ Location: __________________________