For more information contact

Transcription

For more information contact
For more information contact
-ICHAEL"ROOKE2ECREATION3UPERVISOR
"RIANNE3TERNAD3ENIOR2ECREATION,EADER
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"EACHSCHOOLS!LLTHETRIPSTHISYEARWILLBEGOINGTO"EAR-OUNTAIN
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4RANSPORTATIONWILLBEPROVIDEDBY!DVENTURES!MERICACHARTERBUS
SERVICE!MENITIESINCLUDE46SBATHROOMANDRECLININGSEATS3KIERS
AREALSOWELCOMETOJOIN
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PLEASE PRINT
PLEASE
DATE:
Plan to rent equipment locally to save time at the slopes.
Olympus Board Shop, Ski Surf Shop, ET and Spyder all provide rentals.
PARENT NAME:
ADDRESS:
PHONE: (
CITY:
)
EMERGENCY PHONE: (
ATTENTION
We are not responsible for lost or stolen items.
Basket check and snowboard check are available
)
STUDENT ATTENDING TRIP:
D.O.B.:
GRADE:
DATES OF TRIP:
1/10
1/24
DEPARTURE LOCATION
DEPARTURE TIME
RETURN TIME
SCHOOL:
1/31
2/7
2/28
3/7
I ALSO GIVE MY PERMISSION FOR ANY NECESSARY MEDICAL TREATMENT/ MEDICAL RELEASE/ CONSENT/ LIABILITY WAIVER
MEDICAL CONDITIONS OR ALLERGIES:
1600 MANHATTAN BEACH BLVD
5:30 AM
9:00 PM
REGISTRATION begins December 1, 2008 at the Manhattan Beach
Parks and Recreation Department located at City Hall (1400 Highland
Avenue). Deadline for registration is 4 days prior to each trip.
For information please contact
Brianne Sternad, Sr. Recreation Leader, (310) 802-5426
Michael Brooke, Recreation Supervisor, (310) 802-5435
INSURANCE CARRIER:
No refunds after registration
GROUP NUMBER:
TRIP DATES
PARENT SIGNATURE:
BEAR MOUNTAIN
PAYMENT (check one)
JANUARY 10, 24, 31
FEBRUARY 7, 28
MARCH 7
FEE FOR TRIPS
CASH:
CHECK:
VISA:
MASTERCARD OR VISA ACCOUNT
MASTERCARD:
Expiration Date
CHECK #:
//
AMOUNT:
//
$65 DOLLARS PER TRIP
All trips include lift ticket, transportation and supervision
LESSONS available at Bear Mountain Ski School for an additional fee.
CUSTOMER SIGNATURE
FOR OFFICE USE ONLY: RECEIPT #
Teen Center Big Bear Snowboarding Trip 2009 Medical Release/Consent/Liability Waiver
Participation in the Teen Center Big Bear Snowboarding Trip 2009 involves activity that includes speeding downhill on a snowboard or skis; there are terrain parks with obstacles and rails with many other skiers and
snowboarders. Snowboarding and skiing involve many falls that can bring injury to wrists and shoulders. Injury to the back, neck, arms, legs, joints as well as sprained muscles, bruises and more serious injury is
possible. This is an inherently dangerous activity with a significant risk of injury. In applying to participate, I assume the risk of this activity including any and all injuries which may ensue. In consideration of acceptance of
my entry to the Teen Center Big Bear Snowboarding Trip 2009 event, I waive any and all claims for myself and my heirs against officials or sponsors of the Teen Center Big Bear Snowboarding Trip 2009, the City of ,
Manhattan Beach, its officers, agents and employees for any claims, demands, injuries, illness, damages, or actions to my person or property arising out of or in connection with or which may directly or indirectly result
from my participation in this event. I hereby hold the City of Manhattan Beach, its employees and agents, and the sponsors and operators of the Teen Center Big Bear Snowboarding Trip 2009 event harmless from all
claims which may be brought against them by myself, on my behalf or by any third party for any such injuries or claims aforesaid. Participants involved in Manhattan Beach Parks and Recreation programs/activities may
be photographed and such photography may be used to publicize City programs/ activities.
Trip Day Hot Line (310) 877-0514
Call for up-to-date information regarding trip on date of trip
We create community and quality of life
through people, parks and programs.