Winter/Spring 2015 Brochure Winter 2015 | Page 19

Registration On-Line Recreation Program Registration! Visit the city website listed below and click on the online registration button to easily and conveniently register for our classes, trips and programs. Be sure to enter the corresponding activity number listed at the end of the program description. The activity number looks like this: #5001. Since this is a fairly new devised program, which is a 2-step process, bear with us as we work out unknown kinks in the new system that may occur. Register online at www.staunton.va.us/recreation *FREE CLASSES: Complete the online registration directions above, ONLY through STEP 1. Once you hit submit after STEP 1, you are registered. NAME ________________________________________________________Year You Were Born_________________________ ADDRESS_________________________________________________________________________________________________ CITY__________________________________STATE__________________ZIP__________________________________________ PHONE AM/PM____________________________________________EMAIL___________________________________________ EMERGENCY CONTACT_____________________________________________________________________________________ Program/Class/Trip_____________________________________________________Date/Time____________________________ $ Price________________ Program/Class/Trip Total (Do not include materials fee) ________________ Adults (Over 55) 10% Discount (excludes trip & special event prices) ________________ Non-City of Staunton Registration Fee add $2.00 per program/class/trip per person________________ Total sent: ________________ The following hold harmless agreement must be signed by all participants or in the case of a minor, his or her guardian. WITNESSETH: WHEREAS, the undersigned in consideration of the permission granted to it by the City of Staunton to hold harmless the City of Staunton against and and all liability, loss, damages, cost or expense which it may incur because of such action, agrees to indemnify and save harmless the said City of Staunton, VA, from any and all liability, loss, damage, cost or expense which the participant may hereafter incur, suffer or be required to pay by reason of said participation in the City of Staunton, VA. The undersigned agrees to pay the complete exoneration of said City, any claim made against the City of injury or damages to persons or property caused by said participation, and to further indemnify and hold harmless said City from any costs incurred with respect to the defense of any such claim. If said participant is a minor child under 18 years of age, the signature of a parent or legal guardian shall constitute the same indemnification as provided above. The Recreation Department may use photos taken during programs/classes/athletics/trips for advertising and marketing purposes, contact the Department if you do not want your image used. SIGNATURE_______________________________________________________________ Travel Policy All trips are to be paid in full when signing up unless another specific option is available where a minimum of 50% deposit is required for each person. Once a payment is received from a patron they are considered to have an official spot on the trip if there is available space. All patrons understand that there is a no refund policy in effect unless the Recreation department decides to cancel a trip. It is at the Recreation department’s discretion on the cancellation of trips and most will be done in a timely manner. In some extreme cases such as death or serious medical conditions a refund may be available to a patron of a trip minus any expense the Recreation department may incur. Name changing fees may occur on trips involving plane flights. In cases regarding deposits; if the balance isn’t paid by the deadline, patron may lose full deposit and spot on the trip. Before registration form is complete, you will be required to sign and date on the line below that you have read, understand and accept this addition to our registration process.If registering for a trip, please list EMERGENCY CONTACT (name, address and phone number): SIGNATURE_______________________________________________________________ Walk-in: Irene Givens Admin Building - Montgomery Hall Park 1000 Montgomery Ave - Staunton, VA 24401 Mail-in: Mail your completed registration form & check to: Staunton Parks & Recreation Department - PO Box 58 - Staunton, VA 24402-0058 www.staunton.va.us/recreation - www.facebook.com/StauntonRecreationParks www.staunton.va.us/recreation 18 14