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Recreation Program Registration Form

2. Participant Information

4. Participant's Name*

5. Participant Shirt Size

   1. Youth Small
   2. Youth Medium
   3. Youth Large

   1. Adult Small
   2. Adult Medium
   3. Adult Large

6. Notes Regarding Shirt

8. Date of Birth*

9. Age*

10. Gender
    -- Select One --MaleFemale

12. School*

13. Grade (2019-2020)
    -- Select One --Pre-KKdg12345678

15. Allergies/Medical Conditions

19. Contact Information

21. Primary Guardian Information

    If participant is a minor. If participant is an adult type N/A in Guardian and Relation fields

22. Relation

24. Address*

26. City*

27. State*

28. Zip Code*

30. Mobile Phone*

    (XXX) XXX-XXXX

31. Alternate Phone

    (XXX) XXX-XXXX

32. Email *

36. Secondary Guardian Information

37. Relation

39. Mobile Phone

    (XXX) XXX-XXXX

40. Alternate Phone

    (XXX) XXX-XXXX

41. Email

45. Program Information
    To ensure registration, verify openings in the program by calling (586)296-8483 or emailing christinaw@micityoffraser.com . We will not accept registrations for programs that are already filled, and any service fees paid are non-refundable.

    To ensure registration, verify openings in the program by calling (586)296-8483 or emailing christinaw@micityoffraser.com . We will not accept registrations for programs that are already filled, and any service fees paid are non-refundable.

47. Program (s)*

48. Team / Session Requested

    Only applicable for programs with teams or multiple times

50. Team member requests (limit 2 please)

    Only applicable for programs with team divisions.

54. Waiver for Participation by Parent
    In consideration of your accepting my child's entry, I hearby, for myself, my child, my heirs, executors and administrators, waiver and release any and all rights and claims for damage I or my child may have against the City of Fraser, Fraser School District and its representatives, successors and assigns for any and all injuries suffered by myself or my child at any activity sponsored by these groups. Please not that any participants picture may be used for promotional purposes and releases the City of Fraser from any liability thereof.

    In consideration of your accepting my child's entry, I hearby, for myself, my child, my heirs, executors and administrators, waiver and release any and all rights and claims for damage I or my child may have against the City of Fraser, Fraser School District and its representatives, successors and assigns for any and all injuries suffered by myself or my child at any activity sponsored by these groups. Please not that any participants picture may be used for promotional purposes and releases the City of Fraser from any liability thereof.

56. Acknowledgements by Guardian*

    By submitting this form, I acknowledge and accept the following:

    1. I agree to the Waiver for Participation by Parent
    2. I will be automatically registered for the intended program, unless there is a current waitlist, in which case the registration is void
    3. I agree to pay the program fee, however I can cancel the program as outlined in the registration policy, located on the Registration page
58. After submitting this form you will be directed to a payment page. Payment online is accepted via credit card. Approximately a 3.75% service charge will be assessed. If you do not pay on the next page, you will be billed and have 30 days to pay or set up a payment plan. After 30 days a 5% fee will be assessed.

Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit

* indicates a required field