2019 Earth Day Registration Form Question Title * 1. Do you want to be in the parade? Question Title * 2. Parent Name(s): Question Title * 3. Will you be a parent volunteer? Yes No Question Title * 4. Address: Question Title * 5. Phone: Question Title * 6. Email: Question Title * 7. Child #1 Grade: Question Title * 8. Child #2 Name: Question Title * 9. Child #2 Grade: Question Title * 10. Child #3 Name: Question Title * 11. Child #3 Grade: Question Title * 12. 1st Choice Location: Green Bay Trail South End (meet in south Takiff Center lot) Central School/Friends Park/Wayman Green/Kalk Park (meet in front of Central School) Wildflower Sanctuary (meet in front of South School) Lakefront Park/Beach Bluff (meet at east end of Park Avenue) Green Bay Trail South End (meet at Harbor and Green Bay Trail) Skokie Lagoons and Little House (meet at Little House) - Organized Scout Troops Only Question Title * 13. 2nd Choice Location: Green Bay Trail South End (meet in south Takiff Center lot) Central School/Friends Park/Wayman Green/Kalk Park (meet in front of Central School) Wildflower Sanctuary (meet in front of South School) Lakefront Park/Beach Bluff (meet at east end of Park Avenue) Green Bay Trail South End (meet at Harbor and Green Bay Trail) Skokie Lagoons and Little House (meet at Little House) - Organized Scout Troops Only Question Title * 14. Waiver and Release of All Claims Please read this form carefully and be aware in registering yourself or your minor child/ward for participation in the above program(s), you will be waiving and releasing all claims for injuries you or your child/ward might sustain arising out of this program(s).I recognize and acknowledge that there are certain risks of physical injury to participants in the above program, and I agree to assume the full risk of any such injuries, damages or loss regardless of severity that my child/ward or I may sustain as a result of participating in any activities connected or associated with any such program(s). I waive and relinquish all claims my child/ward or I may have against the Glencoe Park District, Village of Glencoe, School District #35 and its officers, agents, servants and employees as a result of participating in any of the above program(s). I hereby fully release and discharge the Glencoe Park District, Village of Glencoe, School District #35 and its officers, agents, servants and employees from any and all claims from injuries, damage or loss which I or my child/ward may have or which may occur to me or my child/ward on account of my participation or the participation of my child/ward in any of the program(s). I further agree to indemnify and hold harmless and defend the Glencoe Park District, Village of Glencoe, School District #35 and its officers, agents, servants and employees from any and all claims resulting from injuries, damages and losses sustained by me or my child/ward, and arising out, connected with, or in any way associated with the activities of any of the program(s). I have read and fully understand the above program details and waive and release all claims. Submit Registration