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Please fill out one form per participant! Return the form and Appropriate fee to: Casselton Parks & Recreation, PO Box 97, Casselton, ND 58012 Current Grade ______________ ACTIVITY___________________________________________________________________ TOTAL FEE ENCLOSED __________ E-MAIL ADDRESS _____________________________________________ PARTICIPANT NAME_______________________________________________________________ ADDRESS_____________________________CITY____________________ AGE____________________ BIRTHDAY _______________ PARENT/GUARDIAN _____________________ HOME PHONE ____________________________ WORK & CELL PHONE ______________________________ DOES THE PARTICIPANT HAVE ANY SPECIFIC LIMITATIONS WE SHOULD BE AWARE OF? ___________________________________________________________________________ T-Shirt Size (Please Circle One) Youth Med. Youth Large Adult Small Adult Med. Signature: ________________________________________ By signing, you agree to the terms outlined below: I (Parent/Guardian) agree not to hold the Casselton Park District, its employees or volunteers liable for any injuries or accidents that may occur during parks and recreation activities or programs. I will not file any claims or seek damages from the park district, its board of directors or its employees.
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