Pass Form for Non-residents of FVPD

in
STEP ONE: Fill in your Family information:
Family Last Name:
Primary Contact:
Address:
Apt. #:
City:
State:
ZIP:
Home Phone:
Cell Phone:
Emergency Phone:
Email:
     
STEP TWO: Fill in each Family member:
     
FAMILY MEMBER #1
#1 Status:
New
Renewal
#1 Full Name:
#1 Birthdate:
#1 Gender:
Male
Female
#1 Current School Grade:
#1 Type of Pass:

What kind of season pass do you want?


NOTE: You may be a Resident for the Aquatic Centers because
you live in the City of Aurora, but only residents of the
Fox Valley Park District qualify as a Resident for Blackberry Farm.

     
FAMILY MEMBER #2
#2 Status:
New
Renewal
#2 Full Name:
#2 Birthdate:
#2 Gender:
Male
Female
#2 Current School Grade:
#2 Type of Pass:

What kind of season pass do you want?


NOTE: You may be a Resident for the Aquatic Centers because
you live in the City of Aurora, but only residents of the
Fox Valley Park District qualify as a Resident for Blackberry Farm.

     
FAMILY MEMBER #3
#3 Status:
New
Renewal
#3 Full Name:
#3 Birthdate:
#3 Gender:
Male
Female
#3 Current School Grade:
#3 Type of Pass:

What kind of season pass do you want?


NOTE: You may be a Resident for the Aquatic Centers because
you live in the City of Aurora, but only residents of the
Fox Valley Park District qualify as a Resident for Blackberry Farm.

     
FAMILY MEMBER #4
#4 Status:
New
Renewal
#4 Full Name:
#4 Birthdate:
#4 Gender:
Male
Female
#4 Current School Grade:
#4 Type of Pass:

What kind of season pass do you want?


NOTE: You may be a Resident for the Aquatic Centers because
you live in the City of Aurora, but only residents of the
Fox Valley Park District qualify as a Resident for Blackberry Farm.

     
FAMILY MEMBER #5
#5 Status:
New
Renewal
#5 Full Name:
#5 Birthdate:
#5 Gender:
Male
Female
#5 Current School Grade:
#5 Type of Pass:

What kind of season pass do you want?


NOTE: You may be a Resident for the Aquatic Centers because
you live in the City of Aurora, but only residents of the
Fox Valley Park District qualify as a Resident for Blackberry Farm.

     
FAMILY MEMBER #6
#6 Status:
New
Renewal
#6 Full Name:
#6 Birthdate:
#6 Gender:
male
Female
#6 Current School Grade:
#6 Type of Pass:

What kind of season pass do you want?


NOTE: You may be a Resident for the Aquatic Centers because
you live in the City of Aurora, but only residents of the
Fox Valley Park District qualify as a Resident for Blackberry Farm.

     
STEP THREE:
Blackberry Farm/Aquatics Season Pass Waiver and Release of All Claims and Assumption of Risk

Please read this form carefully and be aware that in consideration for this Aquatics Season Pass, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with use of the Fox Valley Park District aquatic facilities and programs. I recognize and acknowledge that there are certain inherent risks of physical injury to patrons of aquatic facilities, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities and programs connected with or associated with this Aquatics Season Pass. I further recognize and agree that lifeguards and other aquatic staff are not responsible for supervising my activities or the activities of my minor child(ren) and I agree that I am solely responsible for supervising my minor children and/or assessing whether my children are physically fit and/or adequately skilled for aquatic activities.

I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of use of the Fox Valley Park District's aquatic facilities and programs against the Fox Valley Park District, including its officials, agents, volunteers and employees (hereinafter collectively referred as "District"). I do hereby fully release and forever discharge the District from any and all claims for injuries, damages or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with use of the District's aquatic facilities and programs.

I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims. Registering online and proceeding with my purchase shall have the same legal effect as an original form signature.
 

When done, click:

*Notes: We currently accept only Visa, MasterCard and Discover at this time.

 

 

Events

« May 2013 »
MonTueWedThuFriSatSun
12345
6789101112
13141516171819
20212223242526
2728293031
 
 
 
 
 
 
For Email Marketing you can trust