2006 Newport Recreation Department Registration Form
Please Read and complete the entire form. Only one (1) participant name per form. Extra forms can be picked up at the Recreation Office.
PLEASE NOTE: This is Registration Information ONLY...Registration is NOT COMPLETE until Payment is received in Recreation Office, 222 Main St, Newport, VT 05855. Call for more information 802-334-6345
Child’s Name: DOB Sex: M- F Age: Grade:
Parent/Guardian Name:
Home Phone Number Day Phone Number:
911/Street Address:
Mailing Address:
(If different from above)
Emergency contact: Relationship
Home Phone Number:Day Phone Number
Release: I understand that there are risks of physical injury inherent in participating in sports and recreation activities. I hereby release the City of Newport its employees and agents from any liability or personal injury or the loss or damage of personal property which I or my child may experience in connection with activities sponsored by the Parks and Recreation Department. I hereby consent to any medical procedures deemed advisable for my child in the event that I cannot be reached and my child has sustained an injury. I hereby consent to the use of my child’s photo, video, etc., by the Newport Recreation Department for flyers, presentations, etc.
Code of Conduct -Behavior: Participants are expected to exhibit appropriate behavior at all times, the following guidelines have been developed to make recreation departments programs safe and enjoyable for all participants. Additional rules may be developed for particular programs and athletic events as deemed necessary.
Participants Shall: 1) Show respect to all participants and staff. 2) Refrain from using foul language. 3) Refrain from causing bodily harm to other participants or staff. 4) Show respect for equipment, supplies and facilities.
Registration: A person is not considered registered for a program until payment has been received. Please check the box of programs that your child will be participating in and circle the price. Please make checks payable to the City of Newport. To be a Newport City Resident you must be eligible to register to vote in the City of Newport. Paying property taxes in Newport City does not always constitute residency. Newport Center Residents are NOT considered Newport City Residents
Refunds: Refunds will not be awarded after the first meeting of a program. A $5.00 administration fee will be charged when the participants requests an early refund.
By submitting this form you agree to this registration and your name typed in this box will be considered a valid signature and approval of this information and registration. Date (Parent or Guardian Signature)
Res. Non Res.
Tennis Camp I or II (ages 9-12) $10.00 $20.00
Both Camp I & II (ages 9-12) $18.00 $36.00
Tennis Lessons: Child ( 9-) Free Res. or Non Res. (Included with purchase of a Tennis Pass)
Students ( 10-17 ) Free Res. or Non Res. (Included with purchase of a Tennis Pass)
Individual (18+ ) $13.00 $38.00 Family $18.00 $51.00
Tennis Passes: Child age 9 and under $ 6.50 $20.00 Student age 10 to17 $18.00 $31.00
Individual age 18 and older $31.00 $57.00
Family $51.00 $99.00
Safety Town: Free Free
Track & Field: $8.00 $16.00
Swimming Lessons: $15.00 $26.00
Other
For more information please call the Newport Recreation Office at 802-334-6345