Fall 2026 Registration Form

Registration Form

Please complete your registration by providing your details below.
Participant Information
Participant Information
Term Dates: September 14-November 16, 2026
Location: Gladstone Community Center, 1050 Portland Avenue | Phone: 503-655-7701
Class Selection
Class Selection
Payment must be submitted with registration. Do not enter credit card numbers on this form. Registration forms and payments may be brought to: Gladstone Community Center, 1050 Portland Avenue, Gladstone, OR.
Payment Amount: $
Payment Method
Full Name

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

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date

MonthDayYear
Date
Hold Harmless / Release of Liability I understand that participation in Gladstone Community Center classes and activities may involve physical movement, social activities, and other participation-related risks. I acknowledge that I am voluntarily participating in the selected class or activity. To the fullest extent allowed by law, I agree to release, hold harmless, and indemnify the City of Gladstone, its elected officials, officers, employees, volunteers, agents, and representatives from any and all claims, injuries, damages, losses, or expenses that may arise from my participation in these classes or activities, except where caused by the City's gross negligence or willful misconduct. I understand that it is my responsibility to participate only in activities that are appropriate for my health and ability level. I agree to notify staff of any concerns or limitations that may affect my safe participation.
Participant Signature
Parent/Guardian Signature, if participant is under 18
Office Use Only
Date Received

MonthDayYear
Date
Payment Type
Notes
Payment Received
Staff Initials
Payment Method (office use)
Should be Empty:

Registration Form

Office Use Only