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Your information


Required fields are marked with an asterisk (*).
First Name *
Last Name *
Cell Phone *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, City of Grapevine Parks & Recreation will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
Date of birth *

A valid date as MM/DD/YYYY (for example: 11/30/2015)

Disclaimer

CITY OF GRAPEVINE PARKS & RECREATION

WAIVER OF LIABILITY

1175 MUNICIPAL WAY

GRAPEVINE, TX. 76051

I do hereby release, absolve, indemnify, and hold harmless the City of Grapevine and its employees, activity officials, activity supervisors, any or all of them in the event of any accident, injury or death sustained by the below named participant(s) while being transported to or from an activity, or while participating in any activity from any liability of any kind whatsoever. I agree to abide by all PARD program and facility rules, regulations, policies and procedures, whether posted, written or verbal. Any offensive conduct, discrimination, harassment, sexual harassment, or other conduct offensive to a person, regardless of gender, race, color, religion, or national origin, committed by the participant towards another participant or staff member shall be prohibited and shall result in immediate removal of said participant from all programs and facilities.

PHOTOGRAPHY DISCLAIMER:

I also give permission for any photographs taken during the time of these activities to be utilized for promotional uses by the City of Grapevine, now and in the future.