Registration is Easy! PAYMENTS ACCEPTED:
Summer Classes & Programs May 9, Incorporated Danville residents May 16, Open registration
American Express, MasterCard, Visa, Discover, Exact Cash, Check or Money Order payable to Town of Danville
ONLINE REGISTRATION: www.danville.ca.gov/recguide
• Click the blue Sign In button and log in with your email address. • Select the Activities tab to filter your search.
MAIL/DROP OFF:
Danville Community Center Attn: Class Registrations 420 Front Street Danville, CA 94526
Hours: M-T, 8:00PM-5:00PM F, 8:00AM-1:00PM • NEW account: click the Create an Account link (under the blue Sign In button), and follow the system prompts.
Please print and complete each line. A unique email address is required for each registrant 18 years of age and older.
Name (Parent or Guardian if under 18):___________________________________________ Home Phone: ___________________________ Address: ______________________________________________________ City:______________________________ Zip: ________________ Cell: _____________________________ Email (required): ____________________________________________________________________ REGISTRATION FORM IS LIMITED TO FAMILY MEMBERS ONLY. Check one: o Resident o Non-Resident (for clarification, see page 46.)
o Please check if you have changed your address from last registration. o To assure our programs benefit all who attend, please check here if any participant has a disability requiring special accommodations. Participant’s Name Birthdate Activity # 2nd Choice Activity #
Class Title
Fee
I have read and understand the refund policy. Waiver of Liability: I, the undersigned or parent/legal guardian of the individual named above, do hereby waive, release, and discharge all claims for damages, death, personal injury, property damage which I may have or which may hereafter accrue to me as a result of participation in said activity. I understand that accidents can occur during the said activity. Knowing the risks of the said activity, I hereby agree to assume those risks. This release is intended to discharge and hold harmless the Town of Danville, its officers and employees from liability. This waiver and assumption of risk is to be binding on my heirs and assigns. I further understand that photographs and video may be taken of me during the course of the said activity and that these photographs and video may be used for Town of Danville publicity purposes. I HAVE READ AND UNDERSTAND THIS RELEASE.
Please read refund policy before submitting your registration.
__________________________________________________________ ______________________ Signature Required (o parent) (o guardian) (o participant) Date
PAYMENT METHOD
Mail registration form & payment to: Danville Community Center, Attn: Class Registrations 420 Front Street, Danville, CA 94526
Payment by check or money order made payable to “Town of Danville”: o Check *Credit Card: o MasterCard o Visa o American Express o Discover o Card on File
TOTAL: _______________________
Credit Card No:_____________ –_____________ –_____________–_____________ Exp. Date: ______________ 3- or 4-digit verification code: ______ Signature:_________________________________________________________________________ Payments made by credit card are subject to a 2.99% credit card processing fee.
Register online!
www.danville.ca.gov/recguide
47
REGISTRATION
REGISTRATION DATES:
