Pulaski Township Park Committee Presents ....KIDS NIGHT IN THE PARK (Lock-In)

Pulaski Township Park Committee Presents ....KIDS NIGHT IN THE PARK (Lock-In)

Register your child for this Pulaski Township Park fundraiser and secure your spot with payment. Multi Child discount available at checkout.
Parent / Guardian Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Child's Full Name

First and Last NameAge
Child's Full Name

First and Last NameAge
Childs Name and Age

First and Last NameAge
Are there any allergies or special instruction for any of the children you are registering?
Waiver and Release of Liability

By registering for the Parents Night Out ~ Kids Night in the Park fundraiser, I acknowledge that I have carefully read, fully understand, and voluntarily agree to the terms of this Waiver and Release of Liability.

1. Assumption of Risk
I understand that participation in township-sponsored events may involve physical activity, outdoor conditions, use of equipment, interaction with other participants, and other inherent risks that may result in injury, illness, property damage, or loss. I voluntarily assume all such risks, whether known or unknown.

2. Release and Hold Harmless
In consideration of being permitted to participate, I, on behalf of myself and/or my child, and on behalf of my heirs, executors, administrators, and assigns, hereby release, waive, and discharge Pulaski Township Park and Pulaski Township, including its Board of Supervisors, officers, employees, volunteers, agents, and representatives, from any and all claims, demands, actions, or liabilities arising out of or related to participation in this event, except for claims arising from gross negligence or willful misconduct.

3. Medical Authorization
I authorize Pulaski Township and/or designated event personnel to obtain emergency medical treatment for myself or my child if necessary. I understand and accept full responsibility for any medical expenses incurred.

4. Insurance Acknowledgment
I acknowledge that Pulaski Township does not provide health or accident insurance coverage for participants. I am responsible for maintaining my own medical insurance coverage.
YesNo
YesNo
Parent/Guardian Signature
Date

MonthDayYear
Date
**Tickets are non-refundable but can be saved and used on a future night
Sponsorship Welcome!

Support a child by choosing to sponsor and help with donations.
Choose one to complete registration
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Kids Night in the Park
$20 for first child, $10 Each additional

$20.00 Quantity

Sponsor A Child
Give the gift of FUN and sponsor a child

$20.00 Quantity

Total

$0.00
Payment Methods

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Pulaski Township Park Committee Presents ....KIDS NIGHT IN THE PARK (Lock-In)

Sponsorship Welcome!