SP&R Ski and Board Program Registration
Online Registration for Seekonk Parks and Recreation 2018
Email address *
Please note that completion of this form does not guarantee participation in the Seekonk Parks and Recreation Ski and Board Program. There is limited enrollment. The first 50 applications from each school that have all forms completed, monies paid and agree to follow the rules and conditions of the program will be accepted. Additional names will wait-listed until enough participants(75) are acquired for additional bussing can be procured. If you prefer to do the forms on paper, the forms are available at the Town Hall at the Parks and Recreation Office. Please spread the word. We need 45 persons for each but in order to run the program for that school. As of 12/11/17 we have 53/50 spots filled for the middle school. and 42/50 spots filled for the high school... You will need to have both applications and the check turned in to guarantee your spot. All others will be wait-listed. *
Required
What is the last name of participant? *
Your answer
What is the first name of participant? *
Your answer
Street address of participant? Number/Street/City/State/Zip *
Your answer
What school does your child attend? *
What grade is your child in? *
What T-Shirt Size would you like? *
My child intends to *
Current Skill Level *
Name of Parent/Guardian 1 first/Last *
Your answer
E-mail of Parent/Guardian 1 *
Your answer
Phone of Parent/Guardian 1 *
Your answer
E-mail of Student *
Your answer
Name of Parent/Guardian 2 *
Your answer
E-mail of Parent/Guardian 2 *
Your answer
Phone of Parent/Guardian 2 *
Your answer
Name of Insurance Company and Policy #/Policy Holder(if not know at time put will submit) *
Your answer
Emergency Contact (Name, Number,Relationship) *
Your answer
Are there any health issues that affect the health of the participant that we should be aware of; Allergies(list), Epi-pen, Inhaler, etc. Please be specific. *
Your answer
Is there any special concerns you have about the participant that you want us to know? *
Your answer
If you want to chaperone any or all of the trips please enter your e-mail address below or fill out the form from link below. You will also need to submit a CORI form to the Parks and Recreation Department. https://docs.google.com/forms/d/e/1FAIpQLScezOQnQgBFuTaP7ChddXW18l7n2J96XRG1pxiwFStsn5dVfA/viewform?c=0&w=1
Your answer
Disclosers and Consent: Checking the boxes below indicate that you and the participant agree to and will abide by the rules and regulations provided in the hand book. To download the application, CORI forms, or handbook, go to http://www.seekonkrecreation.com/ski or pick up a printed copy at the Town Hall office of Parks and Recreation. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms