Milton Parks and Recreation
Saturday SPRING 2011 Kelly Field Tennis Lessons
Instructor Qualifications
Dedham Health and Athletic Complex Tennis Staff
Ann Palermo, USPTR Certified Tennis Pro & USTA Team Tournament Player
Nadia Sablon, , USPTR Certified Tennis Pro & Former WTA Tour Player
Tennis Instruction for Ages 5 to 15 years old
* Tennis Lessons for 1.5 hours on Saturdays for 4 weeks
* April 30 - May 21
* No Class or Make Ups on May 28, Memorial Day Weekend
* June 4th Rain Day
Ages 5 - 7 from 9:30am - 11:00am
Ages 8 - 15 from 11:00am - 12:30pm
Questions:
Milton Parks and Recreation at (617) 898-4940
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Saturday Spring 2011 Kelly Field Tennis Lessons
$70 For Four Weeks
Name DOB ________ AGE________
Address_______________________________________________________________________________
E-mail address____________________________________________Home Phone #_________________
Emergency Contact ___________________________________Emer. Phone #______________________
Payment $ Please make check payable to: Town of Milton.
Return with payment to: Milton Parks and Recreation, 525 Canton Ave., Milton, MA 02186
For additional information please contact the Park Office @ 617-898-4940
CONSENT AND RELEASE FORM
I, the undersigned parent/guardian of_____________________________, a minor, do hereby consent to my child’s participation in voluntary athletic or recreational programs of the Town of Milton Park Department.
I also agree to forever release the Town of Milton, the Park Department, and all their employees, agents, board members, volunteers and any and all individuals and organizations assisting or participating in voluntary athletic or recreation programs of the Town of Milton Park Department (“the Releasees”) from any and all claims, right of action and causes of action that may have arisen in the past, or may arise in the future, directly or indirectly, from personal injuries to my child or property damage resulting from my child’s participation in the Town of Milton Park Department voluntary athletic or recreation programs.
I also promise, to indemnify, defend, and hold harmless the Releasees against any and all legal claims and proceedings of any description that may have been asserted in the past, or may be asserted in the future, directly or indirectly, arising from personal injuries to my child or property damage resulting from my child’s participation in the Town of Milton Park Department voluntary athletic or recreational programs.
I further affirm that I have read this Consent and Release Form and that I understand the contents of this Form. I understand that my child’s participation in these programs is voluntary and that my child and I are free to choose not to participate in said programs. By signing this Form, I affirm that I have decided to allow my child to participate in the Town of Milton Park Department athletic or recreation programs with full knowledge that the Releasees will not be liable to anyone for personal injuries and property damage my child or I may suffer in voluntary Town of Milton Park Department athletic or recreation programs.
Signature: ____________________________________________________________________________ Date: _______________________
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