ROBBINS PARK DISTRICT
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Back 2 School Giveaway Registration
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Indicates required field
Name
*
First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Email OR PHONE NUMBER
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How many children are you registering?
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1
2
3
4
Fill out NAME and AGE of each child
CHILD 1 Name
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First
Last
What is the age of CHILD 1?
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5-9
10-12
13-17
CHILD 2 Name
*
First
Last
WHAT IS THE AGE OF CHILD 2?
*
5-9
10-12
13-17
CHILD 3 Name
*
First
Last
WHAT IS THE AGE OF CHILD 3?
*
5-9
10-12
13-17
CHILD 4 Name
*
First
Last
WHAT IS THE AGE OF CHILD 4?
*
5-9
10-12
13-17
How did you hear about this EVENT?
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Internet Search
Advertisement
Friend
Other
What is your household income?
*
Less than $10,000
$10,001 - $25,000
$25,001 - $40,000
$40,001 - $70,000
$70,001 - $100,000
Greater than $100,000
Prefer not to say
TERMS & CONDITIONS
: As a participant, you agree to be photographed, videotaped and grant the Robbins Park District and Robbins Friends of the Park permission to put the finished footage/photography to any uses that it may deem proper including (though not limited to) marketing, advertising and PR related activities (using - though not limited to - print, radio, television, internet and social media). You hereby release, discharge and agree to hold harmless the Robbins Park District and Robbins Friends of the Park, its affiliates, employees, officers, and directors from any liability or claimed liability in connection with the aforementioned use of your photograph, name, likeness or performance, including, but not limited to, any claim you have or might have for invasion of privacy, misappropriation and/or defamation.
The Robbins Park District & Robbins Friends of the Park (“Park”) reserves the right to deny permission to participate in the Event/Activities to any individual, group, company or organization.
Any individual, group, company or organization permitted to participate in the Event/Activities agrees to abide by all rules and regulations now or hereafter promulgated by Park. Failure to comply by any individual, group, company or organization will result in the denial of participation in the Event/Activities. Park will have the sole right to determine any participant’s failure to comply with these Rules of Governance.
The foregoing rules prescribe the terms of participation in the Event/Activities. All participants must adhere to the above Rules of Governance, and any other rules or regulations promulgated by the Robbins Friends of the Park and the Robbins Park District at any time.
I further fully release and discharge and hold harmless the Robbins Friends of the Park and the Robbins Park District, and its officers, staff, employees & agents, and all sponsors from any and all claims from injuries, including death, damages or loss of property which I may have or which may impact me on account of my participation in the event/activities.
I, further agree and grant the Robbins Friends of the Park and the Robbins Park District, and its officers, staff, and agents will not assume liability for any act of God, natural disaster, exposure to adverse weather and conditions, damages, injuries or any legal authority, war, insurrection, civil disobedience, criminal acts, or any cause above and beyond the control of the Robbins Friends of the Park and the Robbins Park District committee and its officers, agents, employees, sponsors.
By submitting this registration form, I accept the terms and conditions.
Submit
Home
About
Meetings
Contact
FOIA
RFPs
Events
Car Show
Back2School
Calendar
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Vendor Application