Wareham's Hometown Guide Recreation Registration Form

Print this form and drop off at the Center
or mail to: Wareham Recreation dept. 54 Marion Road, Wareham, MA 02571

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MAIL IN REGISTRATION FORM:

Name:_______________________________________________________ Age:____________

Address:______________________________________________ Home Phone:_________________
______________________________________________________ Work Phone:_________________
Program Name:_____________________________________________________________________
Time:____________________________________________________ Session:__________________
Fee Enclosed________________________________ (Make checks payable to: 'TOWN OF WAREHAM')
**** RELEASE STATEMENT ****
I hereby give permission for myself or _________________(as his/her legal guardian) to participate in the above named
programs. I agree that the Town of Wareham, it's agents, servants, employees & volunteers are not responsible for injury
or loss. I hold the town harmless from and against any and all claims for injury to above named and his/her property.

SIGNATURE:_______________________________________ DATE:________________

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