2019 WBPR Spring and Summer Youth Sports
Thank you for registering for West Branch Parks and Recreation spring and summer sports. Please contact Park and Recreation Director Melissa Russell at 319-930-0393 or melissa@westbranchiowa with any questions.
Email address *
Parent or guardian name *
Your answer
Parent or guardian phone number(cell phone preferred) *
Your answer
Parent or guardian email *
Your answer
Parent or guardian address *
Your answer
2nd parent or guardian name
Your answer
2nd parent or guardian phone number
Your answer
2nd parent or guardian email
Your answer
2nd parent or guardian address
Your answer
I agree to pay the fee by the deadline. *
Parent’s statement By completing this agreement, I the participant, parent, and/or guardian under-stand that participation in this activity may result in some type of injury and protective equipment does not prevent all injuries to participants. I hereby give permission for my child, ward, or myself to participate in the below registered program and/or activity and certify that my child (or myself) is physically fit to join in the activities. I hereby waive, release, and agree not to hold the City of West Branch Parks and Recreation Department, West Branch Community School District, sponsors, supervisors, and volunteers liable for any injuries that may occur as a result of participation in these activities. I also give my permission for any photos/videos, etc. of these participants taken during a program to be used for future departmental promotional materials. Please take note and govern yourself accordingly. THE WEST BRANCH PARKS AND RECREATION DEPARTMENT AND THE CITY WEST BRANCH HAVE NO ACCIDENT INSURANCE TO PROTECT THE PARTICIPANTS *
Required
Child 1 name *
Your answer
Child 1 current grade or age
Your answer
Child 1- Please check the activities for child 1 *
Required
Child 1 shirt size *
I would be willing to coach or co-coach child 1 *
Child 2 name
Your answer
Child 2 current grade or age
Your answer
Child 2- Please check the activities for child 2
Child 2 shirt size
I would be willing to coach or co-coach child 2
Child 3 name
Your answer
Child 3 current grade or age
Your answer
Child 3- Please check the activities for child 3
Child 3 shirt size
I would be willing to coach or co-coach child 3
Child 4 name
Your answer
Child 4 current grade or age
Child 4- Please check the activities for child 4
Child 4 shirt size
I would be willing to coach or co-coach child 4
Child 5 name
Your answer
Child 5 current grade or age
Your answer
Child 5- Please check the activities for child 5
Child 5 shirt size
I would be willing to coach or co-coach child 5
Special notes regarding registrations:
Your answer
A copy of your responses will be emailed to the address you provided.
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