2010-11-09_PR Comm Packet - Laserfiche WebLink

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n o i Daytime Skating School Winter 2011 - 8 Week Session L ea rn to k ate Program Thursdays, Januar 6 - March 10, 2011 (NO CLASSES ON Jan. 27&Feb. 24) Program # Time Level 9100.496 10:00am-10:30am Preschool 3-4 years old 9100.497 10:30am-11:00am Adult Skating Lessons & Practice ice* 9100.498 11:00am-11:30am 5 years old to early teen *NEW adult skating lessons are being offered on half the ice while children in the daytime skating school are still welcome to use the time for practice ice.Adults are highly recommended to wear protective gear including helmets. ROSEVILLE RESIDENT FEE - $60.00 NON-RESIDENT FEE - $68oOO REGISTER ONLINE @ www.cityofroseville.com/skatingcenter Registration Begins Oct 29, 2010 THERE ARE NO PROVISIONS FOR MAKE UP CLASSES! An$8.00 processing charge will be added to all cancellations. ------------------------------------------------------------------------------------ Parent/Guardian Participants Name: Phone: Name: Home Address: City: State: Zip: Gender circle): F M Birthdate: Status: New Student Returning Student Program# Program Name: Test Passed: Does participant have any disability,allergy or special need of which we should be aware? Explain: co T L T U-) Liability Waiver:I understand that participation in this activity is completely voluntary.I recognize that there are risks in my participation in this v N 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, >_ 0 N my heir,executors,administrators and assigns,to release and discharge the City or Roseville,sponsor(s)of the event or activity,and their v.' M officers,employees,a ents,successors and/or assigns from liability for an and all injury,damage or loss that is or may arise from m T aD g g Y Y J ry� g Y Y CD o U-) participation in this activity. cv oC co 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 information,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. Signature: Date: E-Mail: Fee Paid Date Paid Check# B Visa or MasterCard#: Exp Date The Roseville Skating Center reserves the right to cancel or adjust any session due to insufficient enrollment