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					                                Fathers & Flashlights
                             An Urban Campout Benefiting
                   Friends of West University Place Parks Fund, Inc.
                   Saturday, October 23 – Sunday, October 24, 2010


        Priority Registration for Returning Campers Begins: August 17, 2010
         New Camper Registration Begins: August 24 – September 10, 2010

To participate in this event:
   1. Complete this registration form. Registration is open to families zoned to and
      students attending West University Elementary School. Proof of residency may be
      required.
   2. Complete Volunteer Form and sign Waiver & Consent Form.
   3. Attach $45.00 per father and $40.00 for each child in a check made payable to
      "City of West University Place." After September 10, a $10 per participant, Late
      Registration Fee will be assessed. Please note, this is a rain or shine event and
      there are no refunds! Event proceeds benefit the Friends of West University
      Place Parks Fund, Inc.
   4. Return Registration Form, Volunteer Form, Waiver & Consent Form, and check to the
      registration site listed below during business hours.
   5. Visit www.westuparks.org for additional information.
   6. Get your camping gear ready for some memorable fun!

Registration Sites:
                        West University Place Recreation Center
                        4210 Bellaire Blvd.
                        Monday – Friday, 5:00am–9:00pm
                        Saturday: 7:00am – 7:00pm & Sunday: 8:00am – 7:00pm


       Dad's full name: ____________________________________________________

       Address: __________________________________________________________

       Dad’s Email: ______________________________________________________

       Home Phone: _____________________Dad’s Cell: ________________________

       Please indicate preferred means of communication:  Home Phone  Cell  Email

   Name(s) of child(ren) participating                       Date of Birth   T-Shirt Size




Suggested minimum age: 4 years.
T-shirts available in youth sizes small, medium and large.
                                   Fathers & Flashlights
                               An Urban Campout Benefiting
                     Friends of West University Place Parks Fund, Inc.
                     Saturday, October 23 – Sunday, October 24, 2010




        Priority Registration for Returning Campers Begins: August 17, 2010
         New Camper Registration Begins: August 24 – September 10, 2010


To participate in this event, a volunteering parent is Mandatory:
   1. Mom volunteers make this event a success!
   2. Choose a commitment below that works best for your schedule.
   3. Someone will contact you with your assignment.
   4. Please list your e-mail address and phone number.

           Volunteer’s Name: _______________________________________

           Volunteer’s E-mail:_______________________________________

           Phone: ________________________________________________

Please list your first, second and third choice. If more than one time is listed, please circle
your preference.

Before Event                                  Time                             Priority
Friday, October 22                       9:00am – 11:00am

Day of Event                                  Time                             Priority
Saturday, October 23                     11:45pm- 2:00pm
                                          1:45pm-4:00pm
                                          2:45pm-5:00pm
                                          3:45pm-6:00pm
(Circle One)                              5:45pm-8:00pm                 (Circle One)

                                          6:45pm-9:00pm


Breakfast and Clean-up                          Time                           Priority
Sunday, October 24                Pick up/deliver breakfast by 7am
                                            6:45-9:00am
                                           8:00-10:00am




                                                                   STAFF USE ONLY

                                                                   Date Received: __________

                                                                   Time Received:__________
                                   Fathers & Flashlights
                               An Urban Campout Benefiting
                     Friends of West University Place Parks Fund, Inc.
                     Saturday, October 23 – Sunday, October 24, 2010


                                      Waiver & Consent Form

I, ___________________________________________, the undersigned father or guardian of a
participating child of family, in signing this waiver, assume full and sole responsibility for the safety,
health, and well being of all members of my family, friends, and guests for the duration of the
October 23-24, 2010 "Fathers & Flashlights" neighborhood event.

In signing this waiver I release from any and all liability all sponsors, coordinators, volunteers, the
City of West University Place, Tri-Sports, Houston Independent School District and founders as
individuals or as employees of any company or group, for any inconvenience, injury, illness, or other
malady albeit directly or indirectly related to the "Fathers & Flashlights" event.


In signing this waiver I am indicating that I have read this waiver and understand its content and
implications and in doing so assume full responsibility for the well being, health, and safety of my
family and participants whom I have invited to participate in the "Fathers & Flashlights" camp out and
associated events.

                        City of West University Hold Harmless Waiver

We have asked to participate in the above-described activity of the City of West University Place,
Texas ("City"). By signing below, we agree to the following on behalf of ourselves and all others
claiming by, through or under us:
1. Rules. We agree to abide by the City's rules and policies for this activity.
2. Inspection and Acceptance. The City has allowed us to inspect the areas, facilities, conditions,
vehicles and equipment of the activity. We accept all of them. We accept and assume all risks and
hazards relating to participation in the activity. We have obtained insurance to cover claims
mentioned below.
3. Release. With respect to any claims for injury to either of us (including any injury causing death)
and any claims for loss of, or damage to, property, we agree to the following: (1) the City shall not
be liable or responsible for any of these claims; and (2) we release the City from any responsibility or
liability for these claims and agree not to sue the City on any of these claims. We understand that
the word "claims" includes all of the following that have arisen, or may arise later, in connection with
the activity, whether known or unknown: claims, demands, causes of action, losses, costs, liabilities
and related expenses, including those involving the joint or sole negligence of the City, those
involving the negligence of ourselves or others and those which arise otherwise. (The word "City", as
used in this document, includes the City as an entity as well as its officers, agents, employees,
receivers, representatives, contractors, sponsors, committees, organizers, volunteers and all others
acting on its behalf.) We understand that our photo or likeness may be used in any promotional
materials and/or publications that the City may deem fit.
4. Limitation of Liability. If, notwithstanding our intent, the release written above is not effective for
any reason, we agree that the City's liability for any loss or damage relating to the activity shall be
limited to the sum of $100 per occurrence. This limit applies to all losses or damages, irrespective of
cause or origin, whether in tort, contract, strict liability or otherwise.


_______________________________                     Date: ___________
Adult Participant

				
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