LUMBERTON RECREATION 2009 Adult YOGALATE'S Fall Session by bestt571


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									           LUMBERTON RECREATION
        2009 Adult YOGALATE’S Fall Session
Fee:                         $60/resident, $70/non-resident
Program Location:            Bobby’s Run School
Time:                        7:00pm to 8:00pm
Dates:                       This 6 week program will be held on Wednesday’s
                             9/30, 10/7, 10/14, 1021, 10/28, and 11/4/09.

Power Yoga and Pilates Mix. Great Core Workout.
Please bring a rubber exercise mat and wear comfortable clothing and shoes. You
can find an exercise mat at many department or sporting goods stores.
Please check here if you do not wish to be included in our electronic Recreation Newsletter_____

Participant’s Name
Complete Address
Email address_________________________________
Home Telephone #                                      Work #
Participant’s Physician                               Tel. #
In case of emergency                                  Phone #___________________
Please list any physical or handicap restrictions related to the above participant.

PLEASE READ/SIGN I,                                               , am registering to
participate in all activities of the above registered program. In case of emergency,
I authorize the programs assigned personnel to administer first aid treatment,
transport me to the hospital mentioned above if necessary, and notify my family as
quickly as possible. In the event of an emergency due to accidents beyond their
control, I hereby release Lumberton Department of Recreation, its supervisors,
employees and program volunteers, from all liability.

Signature                                                 Date

                     DATE PAID______ RECEIVED_________ CHECK #______ $________

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