Recreation Worcester Registration - Summer Program

Recreation Worcester's six week Summer program focuses on team work, sports, arts and fun learning delivered by local youth workers and community partners. Youth will be offered different options of activities to choose from guided by the Recreation Worcester staff team. Registration is required to participate in programming.

NOTE: In addition to the below registration form, please complete our Additional Information Sheet.

Please complete additional form submission(s) if you wish to register more than three children.

Participant Information




MM/DD/YYYY

    

Please list any and all allergies to food or medications for both children.




MM/DD/YYYY

    

Please list any and all allergies to food or medications.




MM/DD/YYYY

    

Please list any and all allergies to food or medications.

Parent/Guardian Information




Example: 5085551234


Example: 5085551234









Example: 5085551234


Example: 5085551234




Emergency Contact Information




Example: 5085551234

Example: 5085551234








Example: 5085551234

Example: 5085551234





Your child(ren) can be released from the program to the following individuals (Please list if different from the above emergency contacts):

Release Consent








Registration Information


Please select which park your child(ren) will attend.

    

    

*For grant funding purposes only.

By checking the following box, I, parent/legal guardian of registered participant(s), hereby understand that:
  1. I am registering my child as a participant in the Recreation Worcester Program.
  2. My child is between the ages of 7 and 13.
  3. My child must remain at the recreation site at all times unless other agreements have been made.
  4. My child must be picked up no later than 5:30 p.m. unless he/she is granted permission to walk home from the site. Continued violations of this rule will result in my child's termination from the program.
  5. My child may be removed from the Recreation Worcester Program for misbehavior.
  6. All required information being provided in this registration form is both accurate and true.
  7. I must provide and keep current all emergency contact information regarding my child.
  8. Recreation Worcester and its affiliated partner agencies are not responsible for lost, stolen or damaged items.
  9. I understand that it is not recommended that the participant bring any electronic devices such as cell phones, iPods, mp3 players, headphones, etc.
  10. The program recommends participants to bring a backpack, water bottle and sunscreen daily.


  

City of Worcester
Customer Service Line
Monday - Friday
7:30 a.m. - 5 p.m.
508-929-1300
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