WHEN: Tuesday's - 6pm-7pm
(August 30th, September 6th, 13th, 20th, October 11th, 18th, 25th, November 1st
WHERE: Lake Peekskill Community Center
COST: $120 for Entire Session (8 Classes) / $18 Per Class
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Liability Emergency Medical Release:
I hereby give my permission to participate in the town sponsored Putnam Valley Parks & Recreation program. I certify that I am physically fit and that I will not hold PVPR or its agencies and/or representatives liable for any accidents and/or injuries incurred during the course of the program. I give my personal consent to be transported to any emergency facility if injury is sustained. I also consent to any treatment, surgery, diagnostic procedure or the administration of anesthesia that may be deemed necessary based on the medical judgment of the attending physician. PVPR will not tolerate abusive language or any type of misconduct at any of its functions.
Name of Participant:
Which Classes are you signing up for?
I understand this informed Consent Form & agree to its conditions. Participant Name & Date:
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