PROP BASKETBALL CLINIC

Where: DLC Warren Gym When: Saturday, February7, 14, 21, & 28, 2015 Time: 11:00AM to 12:00 Noon

PROP will be sponsoring a four week basketball clinic for all DLC students. (All ages) We will place the students into groups according to age and ability. A parent/guardian must accompany the child at all times. Some DLC staff will assist. The staff is there to assist not to watch any individual child.

Register ASAP! All students are accepted.

FILL OUT AND SIGN ALL THREE FORMS!!!

Any questions contact Barbara Flynn at 908-451-7008 (cell)

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Send forms back to PROP MAILBOX through your student’s backpack

Child’sName______Age______

Phone#______E-mail______

Phone & email especially necessary for February session should building close due to weather.

DLC Site (please circle) New Providence Warren

Teacher/Class______

For new sign-ups - Please fill out and sign the two attached forms and send all 3 forms back!! For returning B-ball players - you’ll only need to complete this page

Morris-Union Jointure Commission

340 Central Avenue

New Providence, NJ 07974

“Basketball Clinic”

Parental Release from Liability for Use of the

Developmental Learning Center-Warren Gymnasium

2014-2015

I hereby give permission for my child, , who attends

(Please Print)

the Developmental Learning Center - , to participate in the after school “Basketball Clinic” at the Developmental Learning Center-Warren, offered by Parents Reaching Out to Parents (“PROP”), the parent support group representing the Developmental Learning Centers. I hereby acknowledge and understand that neither the Morris-Union Jointure Commission, its employees, Board of Education members, and agents, or PROP, its volunteers and agents, shall have any liability as a result of any injury arising from my child’s or my child’s adult guardian’s usage of the Developmental Learning Center-Warren gymnasium. I understand that the term “usage” includes not only access to and use of the gymnasium area but also access to and use of rest rooms and the entire property area in, around, and at the Developmental Learning Center-Warren. I further indemnify and hold harmless the Morris-Union Jointure Commission and its employees, Board of Education members, and agents as well as PROP and its volunteers and agents against any claims arising out of my child’s or my child’s adult guardian’s usage of the Developmental Learning Center-Warren gymnasium, including but not limited to the rest rooms, gymnasium, and entire property area in, around, and at the Developmental Learning Center-Warren.

This release is effective for the 2014-2015 school year, commencing on September 1, 2014 and concluding on August 31, 2015. I further understand that I am responsible to abide by all of the rules and procedures set forth by PROP for usage of the gymnasium at the Developmental Learning Center-Warren and that failure to abide by these rules and procedures will result in the automatic suspension of my child’s privileges of accessing the Developmental Learning Center-Warren gymnasium for the PROP-based “Basketball Clinic.”

Home Address:

Parent Name – Please Print

Home Telephone:

Cell Number:

E-Mail:

Parent SignatureDate