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Winter UTLT 2014
Programs begin the week of January 6th

Dodgeball for grades 3-5 (Fast Athletics)                                                                   Fee: $65/ 7 weeks
3:45-4:45           1/6, 1/13, 1/27, 2/3, 2/10, 2/24, 3/3

Floor Hockey for grades K-2 (Jenny Morris)                                                                        Fee: $55/ 7 weeks
3:45-4:45                1/7, 1/14, 1/21, 1/28, 2/4, 2/11, 2/25

WEDNESDAYS (GLENWOOD)~ ~(17 kids max)
Kids Zumba /Yoga for grades 3-5 (Kate Mellecker)                                                Fee: $35/ 4 weeks
3:40-4:40pm               1/22, 1/29, 2/5, 2/12
Super Sports for grades K-2~ (Fast Athletics                                                                        Fee: $65/ 7 weeks
3:45-4:45               1/8, 1/22, 1/29, 2/5, 2/12, 2/26, 3/5

Floor Hockey for grades 3-5    (Jenny Morris)                                                                    Fee: $55 / 7 weeks
3:45-4:45                    1/16, 1/23, 1/30, 2/6, 2/13, 2/27, 3/6

To register, fill out the information below and mail it or drop it off to Rutland Recreation, 250 Main St. (508)886-0048~ No later than FRIDAY, January 3rd. (Pease do not send forms to the school).Make checks payable to “Rutland Recreation”. We will contact you if class is cancelled due to lack of enrollment. Class size is limited. Confirmations are not sent.~ Please send a note to your child’s homeroom teacher making them aware of their participation. Please send a peanut free snack with your child.~ If school is cancelled or there is an early release there will NOT be class.
Student’s Name: __________________________           Age:______     Grade: ______
Parent’s Name: _____________________ E-mail: ___________________________
Home Phone: ________________ Cell/Work Phone: _________________________
Medical Considerations: _________________________________
Teacher: _________________      Naquag           Glenwood
Program Name/Day: ________________________ Fee: $_______
I agree not to hold responsible the Rutland Recreation Commission; the Town of Rutland; the owners of the premises where the program is held; or any of the parties connected with the program for any injury or accident that may occur during the program.~ I understand that if my child becomes a discipline problem, he/she will be dismissed from the program.~ No money will be refunded.~ I also grant permission for the Recreation Staff to seek medical care for my child in the event that a family member cannot be reached.~ (All participants in any town recreation program must complete this waiver.)
Please initial if pictures taken of~ any listed participant during a recreation program may be displayed _______

Town of Rutland 250 Main Street, Rutland, MA 01543   Disclaimer
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