Westland Parks and Recreation Mail In Registration Form (Please Print) 

Student Name: ___________________________________________________________

 Home Phone: ____________________Work Phone: _____________________________

Address: ________________________________________________________________

E-Mail Address: __________________________________________________________

Birth Date: ________________ Grade:_________ School: _________________________ 

Class/Activity: ____________________________________________________________

Day(s) ___________________ Time: _________________ Cost: $__________________ 

Class/Activity: ___________________________________________________________

Day(s) ____________________Time: _________________ Cost: $_________________ 

Class/Activity: ___________________________________________________________

Day(s) ___________________ Time: _________________ Cost: $__________________

Class/Activity: ____________________________________________________________

Day(s) _____________ Time: _________________ Cost: $_________________________ 

NOTE 1:         ALL CLASSES, EVENTS, ETC. ARE HELD AT THE BAILEY CENTER UNLESS  OTHERWISE  STATED

NOTE 2:         MAKE CHECKS PAYABLE TO CITY OF   WESTLAND UNLESS OTHERWISE STATED

NOTE 3:         MAIL REGISTRATION AND PAYMENTS TO:WESTLAND PARKS AND RECREATION, 36651 FORD ROAD, WESTLAND, MI. 48185 UNLESS OTHERWISE STATED.

 I agree to waive all claims, in case of accident or injury, against the City of Westland Parks and Recreation Department, its employees or representatives. 

_______________________________________________________________Signature

 (If minor, signature of parent or guardian)    

Date: _____________________________________________(Please print parent or guardian name)No refunds will be given after the first class.  A 20% administrative fee will be charged on all class refunds.  NO EXCEPTIONS.  Refunds may take up to 6 - 8 weeks to process.  Additional registration forms are available at the Bailey Center. 

For Office Use Only________  _______    _________________   ___________ 

                                    Date             Amount $                           Receipt #                  Initials