Recreation Dept Registration Form
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Registration Policies:
1. All in person registration will take place at the Registration Office during posted office hours, and at Village Offices between 9am and 5pm.
2. Anyone residing outside the boundaries of the Village of Palos Park (in unincorporated Palos Park or in neighboring communities) may enroll in any activity for an additional $5 fee per activity.
3. The Recreation Department of the Village of Palos Park assumes no responsibility for personal injuries or loss of personal property while attending a Recreation Department sponsored activity.
4. Programs may be cancelled due to low enrollment: a refund will be given,

Activities Registration Form
Village of Palos Park
Recreation Dept. 708-671-3760 (print and mail today)

Participant's Last Name:______________________________
1. Program Code________Prog. Name_________First Name___________Age____
                    Birthdate____________Grade Level_________Fee_________
2. Program Code________Prog. Name_________First Name___________Age____
                    Birthdate____________Grade Level_________Fee_________
3. Program Code________Prog. Name_________First Name___________Age____
                    Birthdate____________Grade Level_________Fee_________

Address__________________________________Town_____________Zip________
Phone___________________Health Limitations_______________________________
Emergency phone____________________________

Signature of Parent/Guardian_________________________________

Make Checks Payable to:
Village of Palos Park
8901 W. 123rd Street
Palos Park, IL 60464