Village of Lewiston Recreation - Kids Oil Painting Class - December Session
Village of Lewiston Recreation Address: 145 N. 4th Street, Lewiston, NY 14092
Contact us at (716) 754-1990 or recreation@villageoflewiston.com

RELEASE OF LIABILITY
In consideration of permitting the below-named child to participate in games, practices, and other activities of the Village of Lewiston Recreation Department, I, the undersigned as parent or guardian of said minor, do hereby release and agree to hold harmless the Village of Lewiston Recreation Department and its said agents, employees, coaches and volunteers from any liability for bodily injury, personal injury or property damage which may occur to said minor on the part of said program or its agents, employees, coaches and volunteers related to this program.

Village of Lewiston Recreation Department
COVID-19 Screening Questionnaire will be required to be completed at the beginning of every class.

The following is a current list of COVID-19 symptoms that have been identified by the Center for Disease Control and Prevention (CDC):

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore Throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

If your answer is “YES” to any of the COVID questions below, please do not enter the Recreation Facility.
Child's Last Name *
Child's First Name *
Which class would you like to be signed up for?
Child's Age
Home Address
Phone Number *
Parent's Email Address *
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