Teen Fitness Orientation Application

Parent/Guardian Information

First Name

Last Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Emergency Contact

First Name

Last Name

Phone Number

Teen Participant Information

Birthdate

First Name

Last Name

Email Address

Phone Number

Teen Fitness Consent & Agreement

I understand that the City of Chandler does not carry accident insurance for these programs. I agree to indemnify and hold harmless the City of Chandler from all losses or injuries sustained during my, or my child’s, participation, regardless of whether or not those losses or injuries are caused in part by the City of Chandler. I also give my permission for any photos/video taken of participants to be used by the City of Chandler.

By signing below, we acknowledge we watched the fitness video and understand and agree to Tumbleweed Recreation Center’s rules, regulations, and policies.

Parent/Guardian E-Signature

Date

Teen/Participant E-Signature

Date

Explore Chandler

Chandler Residents

Chandler is Open for Business

A Message From:

Mayor Kevin Hartke

Teen Fitness Orientation Application