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Parks and Recreation

marana.parks@maranaaz.gov

13251 N. Lon Adams Rd. Marana, AZ 85653

(520) 382-1950

MARANA PARKS & RECREATION - SENIOR MEMBERSHIP FORM

ACCOUNT INFORMATION

Please select one:
Date of Birth:
Gender:
Residential Address:
Mailing Address: (If different from above)

EMERGENCY CONTACT INFORMATION

ADDITIONAL SENIOR MEMBER

Date of Birth:
Gender:

ONLINE ACCOUNT

Access your Marana Parks & Recreation account online and register for activities at: http://www.maranaAZ.gov/registration

RELEASE AND INDEMNIFICATION AGREEMENTS

In consideration of acceptance into the above-referenced Town of Marana activity, I do hereby, for myself, my child/ren, my heirs, executors and assigns, release the Town of Marana and the officials, officers, agents and employees of the Town from liability for any harm, injury, or damage, which I may suffer while participating in the above-described activity. This includes all risks that are connected with this activity whether foreseen or unforeseen. I agree to indemnify and hold the Town of Marana and its agents, officials and employees harmless from any damage to persons or property, resulting from my negligence and/or intentional acts. I assume the responsibility of mental and physical fitness for myself to participate in said activity, and agree to abide by all rules and requirements of the activity. I am of lawful age and legally competent to sign this Agreement for and in behalf of myself. By signing below, I acknowledge that I have read and understand the terms of this Release and Indemnification Agreement and agree that I shall be bound by its terms and conditions.

NOTE: All activities are subject to change. Program will be closed on Town observed holidays.

I certify that I am the named applicant in the attached application.

Signature of Account Holder
Date:
Date Picker