Skip to content
Skip to left sidebar
Skip to footer
Menu
Home
East Helena Pool
City Attorney
City Departments
Contact
Forms
Job Opportunities
Administration / Utility Billing
Public Works
Facilities / Parks
Public Notices / City Ordinances
Planning / Zoning / Building
Police Department
Search:
Session 3 Level 1, 11:15-12:00: July 14th-24th
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Session 3: July 14th-24th: 11:15-12:00; Level 1
*
Check here
Please verify and acknowledge: July 14th-24th, 11:15-12:00, Level 1 for your child. Form must be completed with payment processed or slot will not be reserved
Childs Name
*
First
Last
Age
*
Parents Name
*
First
Last
Phone
*
Email
*
Acknowledgement
*
Check here
There is ABSOLUTELY NO REFUNDS. Please check this box to acknowledge
Registration Fee
*
Price:
$45.00
Payment
*
PayPal Checkout
Credit Card
Card Number
Expiration Date
Security Code
Card Holder Name
Waiver
*
Check here
WAIVER FOR PARTICIPATION: In consideration of your accepting my child’s registration, I hereby for my child, my heirs, executors and administrator, waive and release any and all rights and claims for damages I or my child may have against the City of East Helena and it’s employees, representatives and successors for any and all injuries suffered by my child at the activities for which i am registering my child. Please check this box to acknowledge, and then sign and date below
Session Phone
Signature
*
Clear Signature
Date
*
Submit