Village of Lewiston Recreation - One Mile Fun Run - Spring Fling Registration Form                                                          
Village of Lewiston Recreation Address: 145 N. 4th Street, Lewiston, NY 14092
Contact us at (716) 754-1990 or recreation@villageoflewiston.com
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Date: Sunday, May 12, 2024 - Race Starts at 11:00am Sharp - Check-In from 10:00am-10:50am
RELEASE OF LIABILITY
In consideration of permitting the above-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 Dept. 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.

* In order to receive an application next year please provide a valid email address.  Your email address will not be shared with any other organization; it is strictly for our use to distribute our registration form cost effectively and quickly.

Child's Last Name *
Child's First Name *
Parent's Full Name *
Address *
Town *
Zip Code *
Phone Number *
* Parent Email Address
Age Group - Medals and T-Shirts for All Kids 14 and Under *
Required
Date of Birth *
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Sex
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Emergency Contact Name
Emergency Contact Phone Number
Any medical conditions we should be aware of?
T-Shirt Size *
Required
A copy of your responses will be emailed to the address you provided.
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