Village of Lewiston Recreation Pickleball Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Village of Lewiston Recreation Address: 145 N. 4th Street, Lewiston, NY 14092
Contact us at (716) 754-1990 or recreation@villageoflewiston.com

Pickleball:
Tuesdays 1-3pm (November 22, 2022 - April 18, 2023)

This form needs to be completed once per season for emergency contact purposes.

RELEASE OF LIABILITY
In consideration of permitting myself to participate in games, practices, and other activities of the Village of Lewiston Recreation Department, I, the undersigned as myself, 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 myself on the part of said program or its agents, employees, coaches and volunteers related to this program.

Email *

First Name *

Last Name *

Street Address *

Town *

Zip *

Phone Number *

Email *

Emergency Contact Name *

Emergency Contact Phone Number *

Relation to Emergency Contact

A copy of your responses will be emailed to the address you provided.