St. George Youth Programs Registration 2017-18
Please return this form electronically to prksrec@stgeorgemaine.com or in print form as soon as possible to the Town Office or the St George School Office. Further information and print copies of the registration form are available at the Town Office or on the Parks and Recreation link on the Town of St. George website. You can also sign up for our "Constant Contact" e-mail list on our webpage and have all our announcements delivered to your inbox.

Last Name
Your answer
First Name
Your answer
Boy/Girl
Age
as of Sept 1, 2017
Your answer
Date of Birth
Sample - 04/04/2004
Your answer
Does your child have any health concerns that would be affected by their participation
Yes/No If yes, please identify or explain the concern
Your answer
Please identify all sports below that you anticipate your child will be involved in
Required
Grade in 2017-18
Your answer
Cell phone
Your answer
Home Phone
Your answer
Parent/Guardian Name
Your answer
Home Address
Your answer
Parent e-mail address
Your answer
Emergency Contact Name and Number
Other than parent/guardian
Your answer
Parent Electronic Signature and Date (Please sign below after reading)
I, as parent or guardian, understand that participating in any of the activities above may be hazardous and could result in injury. I certify that my child has my permission and is physically capable of participating. I also assume all risks of injury and I hereby, for myself, my heirs, executors and administrators, waive and release all rights and claims I may have against the Town of St. George, the St. George Parks and Recreation Department, Committee, Boosters and their agents and representatives for any and all injuries suffered by me or my child in any town sponsored programs. I also agree to follow all rules and regulations regarding players, coaches and spectator behavior set forth by the department at all times and locations. I understand that if I cannot adhere to these rules, the person(s) named above will forfeit participation in the department's programs. I have read and understand the above information and agree that the listed participants in this form and I will abide by all the rules set forth by the St. George Parks and Recreation Department. I also understand the St. George Parks and Recreation Department strongly recommends that I/we have accident and health insurance in force when participating in any activity offered to me by the Town of St. George and/or its representatives.
Your answer
Would you be willing to volunteer in some capacity?
Please check off areas you are willing to help and write in sport you would coach.
Do you give permission for the St. George Recreation Boosters to use your child's picture from team photos or game action on their site?
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