Print this page and mail it, along with check or money order to:
Oregon City Parks and Recreation/Carnegie Center
606 John Adams Street, Oregon City, OR 97045
Registration Form 503-722-9816 or 503-557-9199
| Parent/Guardian | |||
| Address | City | State | Zip |
| Day Phone | Evening Phone | ||
| Emergency Contact | Emergency Phone | ||
|
Check One |
|||
|
City of Oregon City Resident |
Non-Resident | ||
| Name of Participant | Age | Activity Name | Dates | Time | Location | Fee |
| Total Fees |
| I give permission for the participant (s) listed above to receive first aid from the personnel of the City of Oregon City. I authorize the participants (s) to attend the City’s activities this season. I hereby release and hold harmless the City, its officers, agent and employees from all claims, actions and demands that may arise from the performance of the activity other than those arising out of the negligence of the City. I agree that pictures taken during City activities may be used for promotional purposes. |
| Participant or parent/guardian signature _____________________________________________ Date ________________ |
|
Staff initials __________ Payment type _______ |