Bindlestiff's Summer Cirkus Stilts Registration

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Monday August 7 - Friday August 11 3pm - 6pm Hudson Riverfront Park. Rain Location Charles Williams Park picnic pavilion, Mill Street.

Saturday August 12 - Hudson Sankofa Parade lineup 12:30 pm 7th St Park. parade kickoff 2pm Warren St - 3pm Riverfront Park

Email *

Youth Name *

YOuth Date of Birth *

Parent /Guardian name *

Address *

Mobile number *

Emergency Contact *

Emergency Contact number *

PERMISSION NOTICES

THERE ARE FOUR SEPARATE PERMISSIONS. PLEASE COMPLETE ALL FOUR.

PERMISSION NOTICE 1: I understand that participation in this activity involves a certain degree of risk. I have carefully considered the risk involved and have given my consent for my child’s participation. *

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