Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Participant's InformationName *FirstLastDate of Birth *Email *Gender *PhoneAddressAddress Line 1City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateFitness InformationClass Interested in *Tai Chi in the ParkForagingGardening/Whole Food CookingBirdwatchingWater WalkersOur Green SpaceChristmas Crafts Y'allHPca Park Management for MembershipClass availability is limited. Classes open to everyone. ***HPca Park Management for Membership is limited to Highland Park homeowners (blocks 4, 5, 6, 8, and 9). This class is to prepare future managers for the park and recreation positions.Years of Experience *Practice Availability *Game Availability *Medical InformationMedical Conditions *Emergency Contact *Allergies *PhoneConsent and AgreementLiability Waiver *I acknowledge the risks involved and agree to not hold the organization liable.Photo Release *I consent for the my photo to be taken and used for promotional purposes.Rules and Policies *I acknowledge that the participant and I, the parent/guardian, agree to abide by the organization’s rules and policiesSignature * Clear Signature Fitness Phone Layout Date of Submission *Submit
