2011-09-06_PR_Packet - Laserfiche WebLink

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tr n mnmmtimmmmmmmrmmrmmrmmrmmrmm oii mmmtimmm SNAG u l�lllou ,.'NI vu�uu,u�v u , (Startming like s - a or Golf! For boys & girls ages 5-6! Fall Series September 8 - October 15 Option 1*-. Thursdays at 3-.25pm AND Saturdays at gam - or - Option 2*-. Thursdays at 4.15pm AND Saturdays at 9:50am *Please note times have changed to accommodate school release schedules. Limited to 12 participants in each session. Must be 5-6 years old. Please arrive 5-10 min. prior to start time & allow 45 minutes for your child to play. Volunteer coaches are also needed. Contact Nicole for details (golf@ci.roseville.mn.us or 651-792-7154). Fee: $69 per 12-Session Series (Six Weeks) No special shoes, skills, clothes or equipment required by the participant ... Roseville Cedarholm Golf Course provides all equipment! Bring a water bottle and come to have fun! (Please do not bring any of your own golf equipment!) SNAG G-Ball grant program was made possible by Player Development Products, LLC. 2011 SNAG G-Ball Fall Registration (birth certificates required for new participants) Child's Name: Birth Date: Age: (must be 5-6 y.o.) Emergency Contact: E-mail: Day Phone: Alt Phone: Street Address: � , rh-to,f"jP1 City: State: Zip: u, Any disability, allergy or special need we should be aware oP? Parent/Guardian Signature: F-1 Option I (Th (4 3:25pm/Sat (4 gam) F-1 Option II (Th (4 4:15pm/Sat (4 9:50am) Total Due: $69.00/6-wk series Checks payable to: Roseville Cedarholm Golf Course Mail/drop off at: 2323 Hamline Avenue North Roseville, MN 55113 Liability Waiver:I understand that participation in this activity is completely voluntary.I recognize that there are risks in my participation in this activity.I agree to accept those risks.I also agree,in consideration for my being allowed to participate in this activity,and on behalf of myself,my heir,executors,administrators and assigns,to release and dis- charge the City of Roseville,sponsor(s)of the event or activity,and their officers,employees,agents, successors and/or assigns from liability for any and all injury,damage or loss that is or may arise from my participation in this activity. Data Practices Act Notice:Pursuant to the Minnesota Government Data Practices Act,you are being requested to furnish certain information that is classified as private under the Act.The City collects such information in order to properly process requests to participate in activities.You may refuse to provide such informa- tion,but such a refusal may affect your ability to participate.The information will be maintained by the City Park and Recreation Department,and may be accessible to anyone in the Department,or in other Departments of the City.