Purchase Tickets for the Rockin the River Concert, October 16, HERE

Father-Daughter Dance Registration

luau dance

 

Father Daughter Dance 

It’s time for a “Luau!” Bring your dad or someone special to the dance. A special treat, photos, flowers and light snacks will be provided. *You can save money by purchasing tickets early.

Date:             Friday, Nov. 12
Time:
            7-9 p.m.
Location:     
Fire Station #56, 125 W. Central Ave.
Cost:             
Pre-sale - $10 per pair
At the Door - $15 per pair
Additional person - $5

 

  • Parent/Guardian's Name * Required
  • Child's Name * Required
  • Additional Child's Name
  • Additional Child's Name
  • Address * Required
  • WAIVER FOR PARTICIPANT/PARENT * Required
    In consideration of accepting my and/or my child'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.
  • 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.
  • $10 Per Pair/$5 each additional child
  • Price: $0.00
  • $0.00
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