Danbury P.A.L Summer Experience Registration Form

Child Information

Parent Information

Emergency Contact Information



To induce the Danbury Police Activities League Inc. to accept registration and permit participation by the above named minor child, I hereby give my permission and consent, agree to release, indemnify, and hold harmless the Danbury P.A.L, its officers, staff, and representatives from any claims arising from any injury to above named minor. I hereby give my consent for emergency care prescribed by duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.

This also gives PAL permission to take photography and/or video of said participant for the purposes of promoting programs on fliers, social media, and other ways PAL sees fit.

I agree to pay all registration fees on timely basis. A fee of $25 will be charged for each returned check

REQUIRED


Fee Structure: Please Check Appropriate Fee

***Multiple Child Discount: $25 Off per Family per Week - No Refunds

EARLY BIRD SPECIAL:
Sign-Up before May 22nd and Receive $10 off per week



Session Schedule: Please Check Appropriate Week or Weeks

AFTER SUBMITTING THIS FORM YOU WILL BE DIRECTED TO A PAYMENT PAGE WHERE YOU CAN PAY WITH ANY CREDIT CARD OR PAYPAL