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<br />I .... <br /> <br />.... <br /> <br /># <br /> <br /> <br />Breakfast with Santa <br />The Lino Lakes Parks and Recreation Department and <br />the Lino Lakes Seniors invite you to join them for a fun- <br />filled morning with Santa and friends. Everyone will enjoy <br />a delicious breakfast and children will have the <br />opportunity to decorate gingerbread cookies, make <br />holiday crafts and have their picture taken with Santa. <br />Registration will close November 27 or when full <br />(whichever comes first). We're sorry, but event day <br />registration is not available. Max: 200. Note: On-line <br />registration is not available for this event. Please <br />use the form below to register. Registrations <br />accepted in person, by mail, by fax or by drop box. <br />Cost: $9 per person ages 24 months to 12 years <br />(includes breakfast, crafts, cookie decorating, and <br />one Polaroid photo with Santa) <br />$5 per person ages 13 & up (includes breakfast) <br />Children 23 months and younger are free <br />Ergj1 Day Dale lime~. .. ..... ...... ...... ... ....... <br />4001A01. Sa 12/9 ~:30~10 a.m. Great Hall Banquet8()()rJ'lCltSt:Joseph'sChurch(171 Elm Street, Uno Lakes) <br /> <br />r------------------------------------------, <br /> <br />Breakfast with Santa Registration Form (Program # 4001.401) 'v. r~..~ I <br /> <br />Be sure to list all paid persons (adults and children ages 24 months & up) attending Breakfast with \;(~1J2:-~ I <br />Santa. Note: all children must be accompanied by an adult. ~;J : '\:} I <br />( J r::.----:( I <br />Cost: $9 (ages 24 months to 12 years), $5 (ages 13 years and up) (,-_~\]:-:. ( I <br /> <br />-" I <br />I <br />I <br /> <br />Payee Name & Address (please print) <br />Name (Last, First) <br /> <br />Address <br /> <br />City <br />Phone (Day) <br /> <br />State <br /> <br />Zip <br /> <br />I Attendees (Please list first & last name of all attendees including payee if attending) <br /> <br />I Name (Last, First) -- please print Age Birthdate M1F Cost <br />I <br />I $ <br /> <br />I $ <br />I <br />I $ <br /> <br />I $ <br /> <br />: Checks payable to: City of Lino Lakes Total Amount Due: $ <br /> <br />IVlSA_MC_ ____-____-____-____ Exp.Date <br /> <br />I Participant Agreement: I, the participant, in consideration of my being permitted to participate in the activity, do herby agree to hold harmless, the Lino Lakes <br />Parks and Recreation Department, City of Lino Lakes, and their employees, and other sponsoring agencies from any and all liability for any personal injury <br />I or death which may occur from my participation in this activity. This waiver includes any injuries which may result from the condition of the facilities and <br />I any improvements hereto. <br /> <br />I Payee Signature Date I <br /> <br />L__________________________________________~ <br /> <br />651-982-2440 <br /> <br />(Evening) <br /> <br />4 <br /> <br />www.ci./ino-Iakes.mn.us <br />