Program flyer here - Clinton Parks and Recreation

CLINTON PARKS AND RECREATION DEPARTMENT
201 Killingworth Turnpike, Clinton, CT 06413 (860) 669-6901
GIRLS SOFTBALL for GRADES 1-3
MONDAYS AND WEDNESDAYS AFTER SCHOOL – 3:00 PM - 5:00 P.M.
Register Early
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Practices begin the week of April 20 weather permitting.
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Games begin the week of May 4 . Season ends June 15th, 2015 (Pizza Party-Rain or Shine)
Photo Day – Wednesday, May 6th, 2015 (Rain or Shine)
Child’s Name: ___________________________________________________________________________
Grade: _________________Age: _________________ Date of Birth: _______________________________
Address: ________________________________________________________________________________
Parent: _______________________________Phone:_________________Cell:________________________
Email Address: ___________________________________________________________________________
Please Note: The majority of our communications are sent via email. Please print your email address clearly. Thank you.
Doctor’s Name: _________________________________________Phone: ___________________________
SHIRT SIZES: Please Circle One:
YM
YL
YXL
Please indicate if your child has any severe illness or allergic reactions that we should know about below:
________________________________________________________________________________________
Name to call in case of emergency (other than yourself) below:
______________________________________Phone_________________Cell ________________________
Did you play on a P&R Softball team last year?
YES or NO
If yes, please indicate the following:
Team: ___________________________________Coach:_________________________________________
Do you want to march in the Little League Parade (Saturday, April 25th)
YES or NO
(Little League Parade Rain Date: Sunday, April 26th)
Do you want to march in the Memorial Day Parade (Monday, May 25th)
YES or NO
Would you be interested in Coaching or Assisting a Team?
Parents Name: _________________________________________________
YES or NO
I give permission for my daughter to participate in any and all Softball Activities. I understand that the Recreation Dept. will not be
held responsible for any injuries as a result of participating in the Softball Program. I also understand that I must carry Accident
(Medical) and Liability Insurance for my daughter. I understand the inherent risks of playing softball. You may also contact my
child’s Doctor in an emergency if I cannot be reached.
Parent/Guardian: _________________________________________Date:__________________
PLEASE RETURN THIS FORM AND FEE TO THE PARK AND RECREATION OFFICE BY
Wednesday, April 1, 2015 Do NOT send this form Back To JOEL!!!
FEE: $35.00 PER CHILD (Fee includes a T-shirt and Baseball Cap)
Make your checks payable to the Clinton Park and Recreation Dept.
Amount Rec’d.: ___________ Check/Cash #: ___________________ Date: ____________