Please print clearly and mail the completed form with your check enclosed to: Fit n Fun, 143 Via La Soledad, Redondo Beach, CA 90277. Alternatively, you may fax it to: 424-204-5042 and mail in your check payment separately. Please make check payable to Fit N Fun.

Participant’s Name & Age: __________________________________________________

Participant’s School: _______________________________________________________

Parent’s Name & Address: __________________________________________________

City, State and Zip: _______________________________________________________

Email Address: ___________________________________________________________

Home Phone No: ___________________________  Work No: _____________________

Sports Class:        Soccer @1 pm___  @3 pm___        T-Ball ____        Basketball ____

Day of the week:                        Monday ______   Tuesday ______  Wednesday______

Payment Method (Cash, Check, eCheck, Credit Card or Money Order):______________

Please list any known medical conditions:______________________________________

How did you find out about our program? 
From family or friend: ____ 
library, church or city park: ____ 
Preschool or Other Sources: ____
Please name your source: __________________________________________

Emergency Contact Name:______________________________ Phone:______________

Please read and sign below

Please Note: Classes may be cancelled if minimum registration is not met by the end of the first day of class. Minimum class size is five.

Refund Policy: A refund will be issued only if a class is cancelled by the City of Rancho Palos Verdes, Recreation & Parks Department or by Fit N Fun. In case of illness or other unforeseen events, Fit N Fun may issue a credit or transfer. Walk-in registration allowed during the first week if space is available. Only parents may register a child.

Waiver Agreement: The undersigned agrees to indemnify and hold harmless ‘Fit N Fun’ and its contractors, management and staff from any liability of claim or action for damages resulting from or in any way arising out of the participation in this program by the by the person registered above. I understand ‘Fit N Fun’ retains the right to use photos taken during sporting activities for publicity purposes.

Adult/Parent Signature:______________________________  Date:______________
(Required)