HARA Run Club Registration- Summer 2018
To register for the HARA Run Club (Mondays, July 9 – August 13 (no class Aug 6), 7:00 – 7:45 pm, ages 8-10), please complete this registration form. The $10 registration fee can be paid in person on the first night.

If you would like to volunteer to assist with this program, please let us know!

For more information, please contact info@hubbardsrec.ca

Name of Participant *
Your answer
Date of Birth *
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/
DD
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YYYY
Name of Parent/Guardian *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Emergency Contact (Name) *
Your answer
Emergency Contact (Phone) *
Your answer
Does the participant have any medical conditions, allergies or special needs we should be aware of? *
If yes, please give specific information and any treatments that may be required (eg EpiPen).
Your answer
Emergency care statement *
Do you give permission for HARA representatives to administer first aid and call a doctor/ambulance in the case of an emergency?
Release of liability statement *
Do you release HARA and its representatives of any and all liability from any injuries sustained whilst taking part in HARA activities?
I give permission for images of my child, captured during regular and special Hubbards Area Recreation Association (HARA) activities through video, photo and digital camera, to be used solely for the purposes of HARA promotional material and publications (for example, program promotion and website), and waive any rights of compensation or ownership thereto. *
Required
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