2016 Spring & Summer

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70 REGISTRATION WAIVER Registration Family Aquatic Center FAMILY AQUATIC CENTER SEASON PASS - 2016 AQUATIC CENTER PASS WAIVER & RELEASE Important Information The Vernon Hills Park District “Park District” is committed to providing safe aquatic facilities and programs and holds the safety of participants in high regard. The Park District continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participants’ safety. However, participants and parents/guardians of minors engaged in aquatic activities must recognize that there is an inherent risk of injury. You are solely responsible for determining if you or your minor child/ward are physically fit and/or adequately skilled for the activities associated with this Pool Pass. It is always advisable, especially if the participant is pregnant, disabled in any way or recently suffered an illness, injury or impairment, to consult a physician before undertaking any physical/aquatic activity. Please understand and recognize that lifeguards are not responsible for providing supervision or assessing your swimming skills or that of your minor child; rather, lifeguards are responsible for enforcing safety rules and responding to emergencies. Adult pool pass holders and parents of minor pool pass holders are solely responsible for supervision of any and all activities contemplated by this agreement. Additionally, children 10 years of age and younger must be supervised at all times by a responsible person, 16 years of age or older. NEVER LEAVE ANY CHILD WITH POOR SWIMMING SKILLS OR 10 YEARS OF AGE AND YOUNGER UNACCOMPANIED BY A PARENT OR RESPONSIBLE PERSON, 16 YEARS OF AGE OR OLDER Warning of Risk Swimming and other aquatic activities challenge and engage the physical, mental and emotional resources of each participant .However, despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury, including but not limited to drowning, head/brain injury, and spinal cord injury. Understandably not all hazards and dangers can be foreseen. The very nature of swimming and aquatic activities are hazardous and risky including but not limited to fatigue and overexertion, poor swimming skills, failing to avoid dangerous areas, failing to follow rules and regulations, failure of lifeguards to locate victims and/or delay in emergency response time, horseplay, diving or cannon-balling into shallow water and striking the bottom or side of the pool or waterslide, inadequate supervision or instruction, lack of conditioning, becoming disoriented, striking other swimmers, striking one’s head on the bottom, slip and falls on the deck or within the locker facility, chemical exposure and all other circumstances inherent to aquatic activities. In this regard, it must be recognized that it is impossible for the Park District to guarantee absolute safety. Waiver and Release of all Claims and Assumption of Risk Please read this form carefully and be aware that in consideration for this Pool Pass, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ ward might sustain as a result of participating in any and all activities connected with and associated with use of the Park District aquatic facilities and programs. I recognize and acknowledge that there are certain inherent risks of physical injury to patrons of aquatic facilities, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities and programs connected with or associated with this Pool Pass. I further recognize and agree that lifeguards and other aquatic staff are not responsible for supervising my activities or the activities of my minor child(ren) and I agree that I am solely responsible for supervising my minor children and/or assessing whether my children are physically fit and/or adequately skilled for aquatic activities. I additionally agree to supervise any children ages 10 and under at all times. I further agree to waive and relinquish all claims I, or my minor child/ward may have (or accrue to me or my child/ward) as a result of use of the Park District’s aquatic facilities and programs against the Park District, including its officials, agents, volunteers and employees (hereinafter collectively referred as “District”). I do hereby fully release and forever discharge the District from any and all claims for injuries, damages or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with use of the Park District’s aquatic facilities and programs. I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims. If registering via fax, my facsimile signature shall substitute for and have the same legal effect as an original form of signature. ___________________________________________________________________________________________________________ NEW HOUSEHOLDS MUST COMPLETE THE INFORMATION BELOW: List all family members that live at this address listed on the front of form: NAME BIRTHDATE CIRCLE ONE GRADE ____________________________________________ _______________ Male Female _____________ ____________________________________________ _______________ Male Female _____________ ____________________________________________ _______________ Male Female _____________ ____________________________________________ _______________ Male Female _____________ (847) 996-6800 N WAIVER Register online at www.vhparkdistrict.org
Soccer Registration FALL 2016 REGISTRATION FORM VERNON HILLS SOCCER CLUB RECREATIONAL SOCCER REGISTRATION Family Last Name _______________________________________ Primary Phone (_______)_____________________ Work Phone (_____)_____________________________________ Secondary Phone (_______)__________________ Address ________________________________________ City ______________________ Zip ___________________ E-mail Your confirmation will be emailed to you Emergency Contact________________________________________ Relationship _____________________________ Emergency Phone #1 (_____)_________________ Emergency Phone #2 (_____)_____________________________ I agree to the waiver on the back of this form. Signature_________________________________ Date_______________ Neighborhood closest to your home: __________________________________________________________________ (Aspen Pointe, Bayhill, Beaver Creek, Cambridge Hts., Carriages of Grosse Pointe, Centennial Crossing, Century Park, Court of Shorewood, Cypress Pointe, Deerpath, Georgetown Sq., Greggs Landing, Grosse Pointe, Hawthorn Club, Lake Park Manor, Lakewood Villas, Menconis Villas, Muirfield Village, New Century Town, Olde Grove Farm, Pinehurst, Plymouth Farms, River Glen, Rivers Edge, Saddlebrook, Santuary Pointe, Shadow Creek, Stone Fence Farms, Sugar Creek, The Willows, Village By the Lake, West Pointe, Westwood, Writers Estates, Other) must be 4 years of age by August 1, 2016) Fee: $110 (on or before July 31, 2016) / $150 (on or after August 1, 2016) www.vhsc.org 71 REGISTRATION FORM - SOCCER BOYS CODE GIRLS CODE VOLUNTEER SIGN-UP Pre-K Boys 20101-PB Pre-K Girls 20101-PG Kindergarten Boys 20101-KB Kindergarten Girls 20101-KG 1 st Grade Boys 20101-1B 1 st Grade Girls 20101-1G 2 nd Grade Boys 20101-2B 2 nd Grade Girls 20101-2G r Creation 3 rd Grade Boys 20101-3B 3 rd Grade Girls 20101-3G 4 th Grade Boys 20101-4B 4 th Grade Girls 20101-4G 5 th Grade Boys 20101-5B 5 th Grade Girls 20101-5G Coach with ___________ Participant ___________________ Age ______ Birthdate ______________ Gender ___ Grade (Fall ‘16) __________ PROGRAM CODE FEE OFFICE USE R / W Initials: Date: Participant ____________________ Age ______ Birthdate _____________ Gender ___ Grade (Fall ‘16) __________ PROGRAM CODE FEE OFFICE USE R / W Initials: Date: Method of Payment: Cash Credit/Debit Card Check #_______ H/H credit _______ Total Paid: $_________ All credit cards are charged & cash and checks are deposited as they are received Make checks payable to: Vernon Hills Park District Charge To: Visa MasterCard Discover Debit Account Number_____ _ ______ ______ ______ Exp Date __________ Cardholder Name ___________________________ Amount $__________ Authorized Signature______________________________________________ Registration forms can be mailed or hand delivered to: Sullivan Community Center, 635 Aspen Drive, Vernon Hills, IL 60061or Lakeview Fitness Center, 700 Lakeview Pkwy, Vernon Hills, IL 60061 Online registration is available: www.vhparkdistrict.org Play Longer, Live Stronger Medical Conditions Please note any allergies, special medications, or additional conditions which may affect participation. Name: ____________ Comments: _______________ ___________________
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New! Event FLICK & FLOAT pg. 10 Pla
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Welcome 1 How To Reach Us: www.vhpa
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3 TABLE OF CONTENTS Welcome .......
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Park Partners 5 The Vernon Hills Pa
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Special Events 7 5K Run/Walk Saturd
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Special Events 9 June 24 July 29 Au
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Family Aquatic Center 11 Family Aqu
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Family Aquatic Center 13 Parties an
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Family Aquatic Center 15 lesson is
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Parent/Tot 6/13-6/22 Day Time 18080
Page 21 and 22: Summer Swim Lessons at the LFC R/NR
Page 23 and 24: www.turtles.vhparkdistrict.org Swim
Page 25 and 26: Early Childhood 23 Toddler Academy
Page 27 and 28: Early Childhood 25 Safety Town We'v
Page 29 and 30: Childcare 27 Little Learners Childc
Page 31 and 32: Preschool 29 Preschool Registration
Page 33 and 34: Afterschool Program 31 HAWTHORN AFT
Page 35 and 36: Dance 33 Summer Dance Program June
Page 37 and 38: Youth Variety 35 Teen Beach Musical
Page 39 and 40: Youth Variety 37 Science Party Work
Page 41 and 42: Youth Variety 39 Music Instruction
Page 43 and 44: Youth Variety/Active Adults 41 Spri
Page 45 and 46: Lakeview Fitness Center 43 LFC MEMB
Page 47 and 48: Lakeview Fitness Center 45 Age Requ
Page 49 and 50: Fitness 47 Fit Mamas As Mamas, we p
Page 51 and 52: Athletics 49 Vernon Hills Community
Page 53 and 54: Athletics 51 Glacier Skating Academ
Page 55 and 56: Athletics 53 Spring Break Fliptasti
Page 57 and 58: Athletics 55 The Libertyville Club
Page 59 and 60: Athletics 57 Cricket Learn the exci
Page 61 and 62: Athletics 59 Adult Co-Ed Kickball L
Page 63 and 64: Tree & Bench Program 61 Tree & Benc
Page 65 and 66: Facility Rentals 63 Sullivan Commun
Page 67 and 68: Facility Rentals 65 PICNIC SHELTERS
Page 69 and 70: Registration 67 SPRING/SUMMER REGIS
Page 71: Family Aquatic Center Registration
Page 75 and 76: General Information 73 Century Park
Page 77 and 78: RT 83 District Park Map 75 ALLANSON
Page 79 and 80: means business ® Business is our p
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2016 Spring & Summer

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