Village of Lewiston Recreation - BINGO for Kids Registration Form - October 7th from 6:30-8pm
Village of Lewiston Recreation
Address: 145 N. 4th Street, Lewiston, NY 14092
Contact us at (716) 754-1990 or recreation@villageoflewiston.com

BINGO for Kids is for children ages 4-16 and parents are welcome to play along!

Bring your friends and family to this community favorite event.

FREE!!

Release of Liability:

In consideration of permitting the below-named child to participate in games, practices, and other activities of the Village of Lewiston Recreation Department, I, the undersigned as parent or guardian of said minor, do hereby release and agree to hold harmless the Village of Lewiston Recreation Department and its said agents, employees, coaches and volunteers from any liability for bodily injury, personal injury or property damage which may occur to said minor on the part of said program or its agents, employees, coaches and volunteers related to this program.

Village of Lewiston Recreation Department
COVID-19 Screening Questionnaire

The following is a current list of COVID-19 symptoms that have been identified by the Center for Disease Control and Prevention (CDC):

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore Throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

If your answer is “YES” to any of the COVID questions below, please do not attend this program.
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Email *
Parent's Full Name *
Full Names of Children who will be present *
Total Number in Attendance
Street Address *
Town/City Name *
Zip Code *
Phone Number *
Email *
A copy of your responses will be emailed to the address you provided.
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