MAIL-IN REGISTRATION FORM

For Parks and Recreation Activities/Events Only
CLYBSA forms will be Available at registration

NAME(S)_______________________________________________________

ADDRESS______________________________CITY___________________ZIP______________

PHONE (day) (____)_________________ evenings (____)_______________________

CIRCLE ONE: RESIDENT NONRESIDENT

PROGRAM NAME________________________PROGRAM DATE(S)______________________

TIME_____________ COST________________ TOTAL ENCLOSED_______________________

Please make check or money order (do not send cash) payable to: City of Center Line

MAIL TO:
Center Line Parks and Recreation
REGISTRATION
25355 Lawrence Blvd.
Center Line, MI 48015

Registration is taken on first-come, first served basis. If program is full upon receipt of mail-in registration, your fee will be returned.

By accepting my registration in the above programs, I hereby understand that I release my rights or claims for damages I may have against the City of Center Line through which this program is conducted or its Instructor or City staff.

Signature (guardian for minors)________________________________________________________
Date________________________Shirt Size (if applicable)__________________________________