Purchase 2022 Dog Licenses

Thursday, January 20 & January 27, from 5 to 7 p.m. in the Civic Center Lobby

For more information click here. 

 

A Family Adventure 

Family adventure photo

Brighten up the winter season! Bring the whole family, dress comfy and wear your athletic shoes because you’ll be moving around at this event. We’ll be making our own soda. You'll enjoy pizza and decorate cupcakes along with interactive, fun organized family games.

This program is for families or adults with children. Parents, grandparents, adult babysitters, etc. Child(ren) must have an adult registered and participating.

Date:                 Thursday, February 17
Location:         W.C. Senior Citizens Center, 10 East Central Ave.  
Time:                 6 - 8 p.m.
Cost:                  $5 per person over 4 years old (*not recommended for children under 3)
Registration Required by Feb. 15

  • Adult's Name * Required
    Parent, grandparent, older sibling (over 18).
  • Address * Required
  • WAIVER FOR PARTICIPANT/PARENT * Required
    In consideration of accepting my and/or my child(ren)'s registration, I, on behalf of said group(s) release any and all rights and claims for damages we may have against the City of West Carrollton Parks and Recreation Department and its representatives, successors and assigns for any and all injuries suffered by myself and any guest of said group(s). I do hereby grant and give these groups the right to use a group photograph or image with or without names, both singly and in conjunction with other persons or objects for any and all purposes including, but not limited to private or public presentations, advertising, publicity and promotion relating thereto. I warrant that I have the right to authorize the foregoing uses and do hereby agree to hold the City of West Carrollton Parks and Recreation Department harmless of and from any and all liability of whatever nature which may arise out of result from such uses. For the consideration stated above, I further agree that in the event any person of said group(s) repudiates or attempts to repudiate such release, I will personally indemnify and save harmless the City of West Carrollton Parks and Recreation Department, its successors and assigns, for any and all loss and damage occasioned thereby.
  • Medical Authorization * Required
    In the event reasonable attempts to contact myself or the Secondary Emergency Contact have been unsuccessful, I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency.
  • Waiver Related to COVID-19 * Required
    The novel coronavirus, COVID-19, has been declared a worldwide pandemic, is extremely contagious and is believed to be spread primarily from person-to person contact. The City has put in place preventive measures to reduce the spread of COVID-19; however, I recognize that the City cannot guarantee that I or my child/children will not become infected with COVID-19 and attending this event could increase my risk and the risk of my child/children of contracting COVID-19. By signing this document, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child/children may be exposed to or infected by COVID-19 and that such exposure may result in personal injury, illness, permanent disability and death. I agree and acknowledge that this Release, Waiver and Indemnification specifically includes any claim, demand, liability, cost, suit, charge or compensation for loss or injury of any kind arising out of or related to COVID-19.
  • $5 Per Person - If you have more than six (6) people in your group you will need to complete two registration forms. Thank you.
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