Summer - City of Longview

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Registration Form Longview Recreation 360.442.5400 1. Fill in desired Program for each Participant Participant Name Date of Birth Session # Activity Location Activity Fee (under 18) Total: 2. Sign the Waiver Checks payable to: City of Longview 1. Please notify the department two weeks in advance if the above participant has a disability needing special arrangements, assistance, or any condition which would limit the participant in this activity. 2. The City of Longview does not provide medical or accident insurance coverage and is not responsible for personal articles lost or stolen. 3. I allow photographs taken during City programs to be published without limitation for non-commercial purposes. 4. I agree to abide by and follow the activity and registration policies and procedures. 5. Assumption of Risk, Waiver and Release I am fully aware of the fact that there are special dangers and risks inherent in this activity, including, but not limited to, the risk of serious physical injury, death or other harmful consequences that may arise or result directly or indirectly to me from my participation in this activity. Being fully informed as to these risks and in consideration of my being allowed to participate in City sponsored activities, I hereby assume all risk of injury, damage, liability and harm to myself arising from such activities. I also hereby individually and on behalf of my heirs, executors and assigns, release and hold harmless the City of Longview, their officials, employees and agents and waive any right of recovery that I might have to bring a claim or a lawsuit against them for any personal injury, death or other consequences occurring to me arising out of my voluntary participation in this activity, except for the sole negligence of the City of Longview. I certify that I am the parent or legal guardian of the participant named above; that I have read and understood the foregoing release and that I join the release without reservation, granting full consent and authorization for the above named person to participate in the activity. Signature of Participant or Parent/Legal Guardian (if participant is under 18) Date 3. Print Family Information Please choose the out of city fee Parent/Guardian Name: In-city Out-of-city Address: City: State: Zip: Day Phone: Other Phone: Email: (Required) Visa Mastercard Exp. Date: Cardholder signature______________________________________________________________ 5. Mail-in or Drop-off: 2920 Douglas Street, Longview 98632 Call-in: 360.442.5400 Fax-in: 360.442.5955 Teen
Volunteers u Information Thanks to our Wonderful, Caring and Giving Volunteers, Sponsors & Contributors Teen Council Cameron Church, Mark Morris High School Anastasia Fischer, RA Long High School Rainee Fogelman, Junior Leaders Katy Jones, Junior Leaders Lacey Jones, Substance Abuse Coalition Caitlyn Park, Cascade Middle School Kessa Portwood, Three Rivers Christian School Jonah Ruhter, Mark Morris High School Jessica Sanchez, RA Long High School Azia Sandhu, Cascade Middle School Haley Walker, Three Rivers Christian School Abbie White, Monticello Middle School Junior Leaders Anastasia Fischer Anthony Evans Ashley Hall Brandon Patroni David Adams Drew Grimes Hannah Cochrane Jaushua Jenson Jim Fisher Katy Jones Maci Johnson Morgan Oleson Rainee Fogelman Randi Wynn Samantha Chidester TJ Starling Yolessya DeLeon Teen Partners Advantage Chiropractic and Massage Therapy Altrusa AmeriCorps Big Brothers & Big Sisters Classics Video Games Records & More Columbia Security Copies Today Crime Victim Advocacy Program Fibre Credit Union Highlands Neighborhood Association Longview Anti Drug Coalition Longview Kiwanis Longview Police Department Longview School District Love Inc. Lower Columbia Mental Health Lower Columbia CAP Lower Columbia College Mark Morris High School Monticello Middle School Mt Solo Middle School R A Long High School Sloan’s Floor Covering Toast Masters Three Rivers Christian School Verne’s Pizza Youth and Family Link Youth Suicide Prevention Program Family Partners St Stephens Church Youth & Family Link Americore Serenity Ponds Music & More DJ’s Father Daughter Ball Volunteers Erin Mueller Julie Lepak Shirley Oscar Yvonne Martin Gary Gray Ryneeze Vegum Donna Belt David Belt John Carey Charles Strozyk Diane Strozyk Raine Emmons Julia Leggett Youth Volunteers & Partners Angie Housley Matt Milligan Michelle Trekas Ken Kelly Leah Byrnes Gary Chapin Sandra Eleman Olivia Falter Adam Davis Kim Falter Eric Frasier Baltazar Garcia Macie Johnson Dan Jones Mike Keck Miranda Kretz Alex Martinez James McCullough John Schapman Austin McLaughlin Ramona McLean Micah Miner Rachel Moore Scott Palmer Aimee Rios Armando Ruiz Norm Strehle Ian Thompson Madison White WSU Cooperative Extension 4H BNSF Railroad CATCH – Coordinated Approach to Child Health Child Care Resource & Referral Columbia Theater Columbia Valley Gardens Elementary Department of Early Learning Family Health Center Happy Kids Dentistry High Step Dance Academy Kessler Elementary School Longview School District Lower Columbia School Gardens Red Canoe Credit Union Robert Gray Elementary St Helens Elementary St Johns Medical Center Special Olympics Volunteers Becky Bernhardt Jarrod Belland Aaron Belland Lori Hendrickson Norm Sterehle Tony Wagner Steve McNally Kiffani Iverson Suzi Iverson Ron DePriest Rich Carnine Cindy Carnine Alyssa Hallowell Bethany Mehling Facility Partners Longview School District Cowlitz Coin Club State Board of Appeals Longview Masonic Lodge Cowlitz County Guidance Association Solid Rock Church Narcotics Annonymous Register Online! mylongview.com/reconline 442.5400 1
Page 1 and 2: Proudly Sponsored by: PeaceHealth S
Page 3 and 4: Participant Initiated Refunds Don
Page 5 and 6: Summer Concerts & Family Events Reg
Page 7 and 8: Ballet A creative movement class em
Page 9 and 10: Olympic Discovery Camps at a Glance
Page 11 and 12: Reptile Roadshow A unique learning
Page 13 and 14: Hip Hop Learn the latest hip hop mo
Page 15 and 16: Game Show Mania A high energy camp
Page 17 and 18: (360) 414-2000 • 1615 Delaware St
Page 19 and 20: Emergency Survival Everyday partici
Page 21 and 22: Longview Named Playful City USA! Th
Page 23 and 24: Belly Dancing Discover belly dancin
Page 25 and 26: Parenting Teens Head On Are you (an
Page 27 and 28: Get Golf Ready in 5 Days Get Golf R
Page 29: Social Club Social Club is a progra

Summer - City of Longview

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