Kettles Crafts

Last Name:_________________________________________________

Home Address:_______________________________________________________

_______________________________________________________

Cottage Phone: ____________________Cell Phone:_________________________

Emergency Phone: _________________E-Mail:_____________________________

Is your family a current paid member of the Kettles Association for 2008? Yes □ No □

· Participants who are not members of the Kettles Association will be charged a fee of $10.00 per week

	Dates	Time	Cost
Crafts (ages 6-12)	Ten Classes - June 30, July 2, 7, 9, 14, 16, 21, 23 28 and 30.	A 9:00-10:30 or B 10:30-11:00	$20 per class

Participants Name	Session	Number of Classes	Fee ($20 per class)
	Session A □ Session B □
	Session A □ Session B □
	Session A □ Session B □
	Session A □ Session B □
Total

Waiver

This is my consent for my family (the “Participants”) to participate in activities organized by the Kettles Association (the "Activities"). In consideration for the Participants being permitted to take part in the Activities, I hereby release and discharge the Kettles Association, its directors, officers, members, employees, agents, independent contractors and volunteers from all claims, actions, causes of action or demands, including claims in negligence, arising out of, or in any way connected with the Participants participation in the Activities, howsoever arising or caused. I declare that this release is binding upon me, my children and each of our heirs, executors, administrators and assigns. I further certify that the participants are all covered by OHIP and/or private health insurance.

Signed: ___________________________________________Date:______________________________

Name (please print):____________________________________________________________________