REGISTRATION

FALL

6 WAYS TO REGISTER

1. Online

Visit our website at www.warrenvilleparks.org and complete the online registration.

2. Mail

Include signed registration form with credit card information (MasterCard, Visa & Discover) or check payable to the Warrenville Park District. Please mail to: Warrenville Park District 3S260 Warren Avenue Warrenville, IL 60555

3. Fax

Fax registration form to 630.393.7282 with complete credit card information MasterCard, Visa and Discover accepted.

4. Walk-In

Recreation Center lower Level Registration Office at: 3S260 Warren Avenue, Warrenville, IL Monday - Friday: 9:00A-5:00P Registration is also accepted at the FitnessNOW Desk. (See page 1 for Hours of Operation)

5. Drop-Off

A Drop Box is located at the Recreation Center, 3S260 Warren Avenue, Warrenville IL. Warren Avenue Entrance, Door #1.

6. Phone

Contact the Warrenville Park District at 630.393.7279 with name, address, telephone number, program details and credit card information. (Visa, Mastercard and Discover accepted)

Registration Information

• Registrations are processed at the Park District Recreation Center at 3S260 Warren Avenue. • Registration is required 7 days prior to start of class to avoid cancellation of program unless otherwise noted. • Your check is your receipt. If you wish a class confirmation, please include a self addressed stamped envelope. • There is a $25 service fee for checks returned for insufficient funds or credit card declines. • When registering in person by credit card, the card holder must be present for signature. • Registrations are not accepted by an instructor. • Registration accepted for accounts in good standing. • Payment is required and will be retained if you wish to be kept on a waiting list. If space does not open up in the program, your payment will be automatically refunded.

Waiver Required

For insurance purposes, participation in Warrenville Park District programs and activities requires a signed waiver. Please sign the waiver section of the registration form. By applying to participate in these recreation programs, each resident/non-resident realizes the inherent risks involved in the program and appreciates the nature of these risks. The applicant holds the park district harmless for any damage caused by participation in these programs. The park district provides no medical insurance. Your fax or online signature will be considered your original signature.

Medical Information

Please provide us with any medical information about the participant when you register. If you or your child have any medical allergies, special needs, or anything we need to know to make your experience safe and pleasant, please provide us with your complete information at time of registration. Medical forms may be required for some programs or classes.

Non-Resident Fee Policy

The Warrenville Park District resident via property taxes contributes to the operation of the park district. A copy of a map showing the park district boundaries is available for review at the Park District Recreation Center. Non-residents of the Warrenville Park District will be required to pay an additional fee per program. This is a flat rate per program and will be added onto the regular program fee at time of registration. Active Older Adult Programs and Trips do not have a non-resident fee charge. Programs offered on Community Unit School District #200 property are available to residents of the respective school district at resident rates.

Equal Access

No participant shall, on the basis of race, sex, creed, national origin or disability, be denied equal access to programs, activities, services or benefits, or be limited in the exercise of any right, privilege, advantage or opportunity. Contact our ADA Compliance Officer, Tim Reinbold at 3S260 Warren Ave., Warrenville, 630.393.7279.

Photography Guidelines

Periodically, photographs and videos are taken of participants during programs, special events, trips or at the parks. These photographs may be used for park district publications and/or newspapers. Please note that we do not identify the people in the photographs. Patrons may be asked to sign a photo release form in certain instances.

Hosting a Party or a Meeting?

Warrenville Community Rent the Building Activity Room!

Visit warrenvilleparks.org or call 630.393.7279 for details.

PRIMARY HOUSEHOLD CONTACT: RECEIPT NO.

Last, First

Address

Phone (hm)

Emergency Name & Phone Zip

(wk)

E-mail Form of Payment: Cash Check Visa MC Discover

Expiration Date

Insert Credit Card Number Above OFFICE USE ONLY Received by staff initials Date Processed by staff initials Date

Check Number Cardholder Name Participants Name First and Last Birthdate Mo/Day/Year Authorized Signature Grade Program Code

FALL

DID YOU…?

• Provide at least two different phone numbers. • Sign your registration form. • Make your check/money order payable to Warrenville Park District. • Provide your credit card information

Program Name Charge Amount Fee

If required, please indicate below important household/family member comments instructors should be aware of: (i.e. food allergies, insects, plants, medicine, etc.)? Yes No Details: The Park District makes reasonable accommodations in recreation programs to enable persons with disabilities to participate. Please specify below any adaptive equipment, personnel or other accommodations you need to participate. Total

WAIVER AND RELEASE Please read this form carefully and be aware that in signing up for and participating in programs/activities, you will be expressly assuming the risk waiving and releasing all claims for injuries you or your children might sustain arising out of these programs. As a participant in these Warrenville Park District programs, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, including death, damages or loss which I may sustain as a result of participating in any and all activities connected with or associated with such programs. I agree to waive and relinquish all claims I may have as a result of participating in the programs against the Warrenville Park District and its officers, agents, servants and employees. I do hereby fully release and discharge the Warrenville Park District and its officers, agents, servants and employees from any and all claims from injuries, including death, damages and losses which I may have or which may occur to me on account of participation in these programs. I further agree to indemnify and hold harmless and defend the Warrenville Park District and its officers, agents, servants and employees from any and all claims resulting from injuries, including death, damages and losses sustained by me or arising out of, connected with, or in any way associated with the activities of these programs. In the event of an emergency, I authorize the Warrenville Park District officials to secure from any licensed hospital, physician and/or medical personnel, any treatment deemed necessary for any immediate care and agree that I will be responsible for payment of any and all medical services rendered. I understand that my child/ward or I may be photographed or videotaped while participating in a Warrenville Park District Program or special event. I give my permission for photos and videotapes of my child or myself to be used to promote the Warrenville Park District through brochures, flyers and social media. Such photos and videotapes will remain the property of Warrenville Park District.