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.i, enr-- <br /> . .i <br /> 0 4. , <br /> \ 4101P <br /> Niro: <br /> Otsego Ride the Rec <br /> iii <br /> nn- <br /> A Tuesdays <br /> July 28 August 25 <br /> 0 040)k <br /> v , 9-11:30am <br /> %���� 0 FEE: $14/person it i <br /> We will provide an opportunity for youth ages 5-14 to take part in an organized, <br /> supervised, open recreation program at Otsego Prairie Park (adjacent to City Hall) <br /> one day a week <br /> Supervision by Community Recreation staff members (including bus ride) <br /> A variety of age appropriate activities. <br /> Course# Pick up/Drop off location Pick-up time Drop-off time Interested? <br /> 430-10 101st&Kohler 7:50 11:40 <br /> 430-11 On Mason Ave at 87th ST 7:55 11:45 registration form g. <br /> Return re l <br /> 430-12 80th St and Maciver 8:00 11:50 Re <br /> 430-13 On 80th St at LeBaux Ave Sery Rd 8:02 11:52 with fee to the Community <br /> 430-14 60th St and McAllister 8:05 11:55 <br /> 430-15 60th St and Needham 8:10 12:00 Recreation office. <br /> 430-16 Oakwood Ave at 67th ST 8:12 12:02 <br /> 430-17 Odean ave at 78th St 8:15 12:05 If you have any questions <br /> 430-18 Ogren Ave at 83rd St 8:20 12:10 please contact us at <br /> 430-19 85th and Oakwood 8:25 12:15 P <br /> 430-20 85th and Packard 8:30 12:20 241-3523 <br /> 430-21 85th St at Page Ave 8:32 12:22 <br /> .3300-7.2223 Riverbend Trir Park-Comm.Center 8:35 12:25 <br /> Queens and 56th 8:38 12:27 r <br /> 24 Park Ave and 92nd ST 8:40 12:30 <br /> 430-25 92nd St and Ohland Ave 8:45 12:35 <br /> 430-26 93rd St and Odean 8:47 12:37 <br /> 430-27 94th St and Odean 8:50 12:40 —.._:_•=... <br /> 430-28 430-28 88th St and Odean 8:55 12:45 <br /> 430-29 If you will be participating,but need no bus transportation e/tea <br /> Community Recreation Registration Form <br /> Complete and return with fee <br /> 1230 School Street,Elk River,MN 55330 <br /> Course# Title Fee <br /> Participant LAST NAME FIRST NAME <br /> If CHILD,Age Parent Name <br /> Home Address City /Township Zip <br /> Home Phone# Work/Emergency# ask for <br /> Any Special Needs? <br /> Visa or Mastercard# Expires <br /> Credit Card Signature Make checks payable to: <br /> COMMUNITY RECREATION <br /> We are collecting this data in order to enroll the participant in a recreation program. The data will be provided to the instructor(s),recreation staff whose jobs require the <br /> data,and in some instances,other program participants. If this data is not provided the participant may not be able to be enrolled in the program. <br /> el AIVER: In consideration of your accepting me or my child's entry.I hereby,for myself,my child,my heirs executors and administrators,waive and release any and all <br /> rights and claims for damages I or my child may have against any participating city of the Community Recreation Board or School District 728 and its representatives, <br /> successors and assigns for any and all injuries suffered by myself or my child at any activity sponsored by these groups. <br /> Signature Date <br />