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<br />CHAIN OF LAKES YMCA AND <br />CENTERVILLE PARKS AND RECREATION <br />PRESENT <br />The 2nd Annual <br /> <br />"PARK PLAY DAYS" <br /> <br />Lamotte Park-Centerville <br /> <br />GAMES! CRAFTS! <br />SOMETIMES WET, SOMETIMES MESSY, <br />ALWAYS FUN ACTIVITIES! <br />Centered around the YMCA core values of <br />CARING, HONESTY, RESPECT, RESPONSIBiliTY. <br />· NEW 3 WEEK SESSIONS! <br />Mon. and Wed. 9:30-11 :00 a. m. 4-6 year aids <br />June 14,16,21,23,28 and 30th <br />Tues. and Thurs. 9:30-11:00 a.m. 7-10 year aids <br />June 15,17,22,24,29 and July 1st <br />· Session Two July 2f1h -August 12". 2004 Watch for future registration infonnatJon! <br />Space is limited so register soon! <br />Pre-register by 5:30 p.m. Wednesday June 2nd $15.00/child <br />Registrations made after 5:30 p.m. Wednesday $20.00/child <br />and accepted as space allows. <br />Registrations by cash or check can be mailed or brought to <br />The Chain of Lakes YMCA, clo Lino lakes State Bank <br />7449 Village Drive, lino Lakes, MN 55014 <br />651-795-9622 <br />Registration Fonn <br /> <br />Parents Name/ Address/Phone f\kJtnber <br /> <br />Child's Name and Age <br />Name and location of class <br />2 Emergency Phone Numbers <br />Doctor's Name, Phone and Preferred Hospital <br />HealthlPhysical Concerns <br />AmolI1t enclosed $ Check Number <br />The YMCA has my permission to use photographs of my child for promotional purposes. Inltials_ <br />As Par~ntlGuardlan of this child, I agree to hold the YMCA harmless from any and all claims. I authorize the <br />YMCA staff to give my child reasonable first aid and to transport my child to a health care facility for <br />emergency services as needed. I hereby acknowledge that the YMCA will assume that either parent of the <br />child may pick up the child at any time during the program unless notified through court documentation. <br />Parent/Guardian Signature Date <br />The YMCA welcomes all who wish to participate, and annually raises funds through our Y Partners <br />campaign to help make that possible. Please let us know if we may serve your family In this way. <br /> <br /> <br />AF <br /> <br />Ty <br />Y\1CA <br />We build strong kids, <br />strong families, strong rommnniries. <br /> <br />~ <br /> <br />- <br /> <br />- <br />