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2. Waiver and Release

   
   

   Any and all participants hereby waive, release, and hold harmless and indemnify the City of Broadview Heights and the Broadview Heights Parks and Recreation Department, their organizers, officers, employees, agents, and sponsors for any and all claims for damage of personal injury to me or loss of property that may be cause by any act or failure to act on the part of the City of Broadview Heights, the Broadview Heights Parks and Recreation Department, their organizers, officer, employees, agents and sponsors. The undersigned further assumes the risk of all dangerous conditions in and about the City of Broadview Heights, the Broadview Parks and Recreation Department property both real and personal and waive any and all specific notice of the existence of such dangerous conditions, if any. By participating in or attending any Parks and Recreation events any and all participants agree to allow publication of any photograph taken of myself/my child for advertising purposes.

   PROOF OF RESIDENCY IS REQUIRED TO RECEIVE THE RESIDENT RATE

   NO ID, NO ENTRY - We will need proof of identity via either state or school ID. 

   
   

4. Drop In Guests*

   Please type the full name, and date of birth of all guests.

6. Address*
8. City*
9. State*
10. Zip Code*
11. Phone Number*
13. Emergency Contact Name *
14. Emergency Contact Phone Number*
16. Parent/Legal Guardian Name *

    Complete if any guests are under 18. 

17. Parent/Legal Guardian Contact Information*

    Phone or email address. Complete if any guests are under 18. 

19. Signature *

    Signature of parent or legal guardian if any participant is under 18. 

20. Date*
    Date

    Date
21. Does Patron Have Valid ID?
    -- Select One --YesNo (must have ID to be admitted into facility)

    ID from all patrons will need to be presented at time of arrival. This ID will count as proof of residency for residents. 

    
    

Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field