Summer Wrestling (7/29/20 Deadline)
Free Half Day (9am – Noon) (6/28/20 Deadline)
Is your child going to attend the 12pm - 6pm program with the South River School System?
Borough of
South River
48 Washington Street
South River, NJ 08882
(732) 257-1999
www.southrivernj.org
FILE•it: Activity Registration
Extended Day (7:30am – Noon) (6/28/20 Deadline)
The fee for the 5-week program for 7:30am start per child:
(1) one child is $100.00
(2) two children is $150.00
(3) three or more children is $200.00
Shirt Size *
If you're child is participating in summer recreation, please attach your child's report card/progress report below. *
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*Extended Day partners with the YMCA*
  • Applicant
  • Participant
  • Volunteer
  • Emergency Contact
  • Code Conduct
  • Medical Release
  • Waiver
  • Payment
Address *
Has your address changed since your last Activity Registration application?
City *
ZIP *
Phone # *
Step 1: Complete Applicant Information
Email Address *
*Please click on the Participant Tab to continue*
Parent/Guardian Last Name *
State *
Parent/Guardian First Name *
You may register the same participant for multiple activities below (must be in the same season). *
Step 2: Complete Participant(s) Information
*Please click on the Volunteer Tab to continue*
Step 3: Volunteering
Activity
If Other
I certify that I am 18 years or older.
*Please click on the Emergency Contact Tab to continue*
We realize that you may be interested in getting more involved to provide a better experience for your son or daughter. If you are interested in getting involved, please fill out the following section and we will get into contact with you to provide more information. Please understand that if interested, the borough may conduct a background check and you may be required to participate in a training course. The borough will cover any expenses associated with such requirements.
Would you like to be a volunteer? *
Step 4: Add Emergency Contact(s)
Please enter the details of all emergency contacts below (minimum of one required). *
*Please click on the Code of Conduct Tab to continue*
*Please click on the Medical Release Tab to continue*
Experience has shown that parents who provide a positive attitude help ensure that the league is a positive experience for all involved. The goal of this recreation league is for our participating children to have fun! With that in mind, we ask that you read and agree to the South River Recreation Code of Conduct before completing registration. This Code of Conduct applies to all applicants along with any other guardians/representatives of each participant.

• I hereby pledge to provide positive support, care and encouragement for my child participating in the upcoming recreation season.

• I will encourage good sportsmanship by demonstrating positive support for all players, coaches and officials at all games.

• I will place the emotional and well-being of my child first; ahead of my desire to win.

• I will refrain from any negative remarks to opposing team players, coaches and fans.

• I will refrain from any negative remarks to opposing team players, coaches and fans.

• I will work to ensure my child participates in a safe and healthy environment.

• I will support coaches and officials working with my child in order to encourage a positive and enjoyable experience for all.

• I will support coaches and officials working with my child in order to encourage a positive and enjoyable experience for all.
Step 5: Code of Conduct
Agreement *
Type Full Name :
Sign With Hand
This information is vital to ensure complete protection should your child need medical treatment: I hereby give my permission for any and all medical
*Please click on the Waiver Tab to continue*
in the event of an accident, injury, sickness, etc., until such time as I may be contacted. I also hereby assume the responsibility for payment of any such treatment. I agree to assume full responsibility and not hold the Borough of South River from any legal liability, injury, or damage to person or property in connection with participation in the Borough of South River activities. I agree that the participant must obey all rules and follow all safety procedures involved with any program, trip or activity established by the Parks & Recreation Department. I agree that the participant must obey the instructors, coaches and referees designated to direct this activity. I certify that, to the best of my knowledge, the participant’s current physical condition is satisfactory for participation in this year’s programs and activities and that the participant is free of any health problems which would endanger the participant. I will inform the Director of Parks & Recreation at (732) 254-4412 should the participant’s condition change at any time. The Borough of South River has my permission, should I be unable to be contacted, to take my child to the nearest hospital/urgent medical care facility. I hereby give my permission and authorization to the hospital and/or medical staff to provide treatment which a physician deems necessary for the well being of my child. I further certify that I have medical insurance to completely cover any and all expenses that could arise from any injury/accident.
Signature
attention necessary to be administered to my son(s)/daughter(s),
Step 6: Medical Release Form
,
Date *
Type Full Name :
Sign With Hand
, understand that all sports have an inherent risk of injury, including but not limited to sprains, cuts
Signature
Date *
I,
Step 7: Waiver and Release
*Please click on the Payment Tab to continue*
bruises, broken bones etc. While the Parks and Recreation Department carries insurance, if an injury occurs I shall use my own health insurance as the primary insurer. I understand that proper supervision is provided for all programs. In case of emergency, I authorize program personnel to administer first aid treatment, secure the services of a physician, transport to the nearest emergency room for treatment in case of emergency and to try to notify me/my contact person. I acknowledge that I am assuming all risks in participating in various programs of the South River Department of Parks and Recreation and I fully understand and have knowledge of potential injuries that may occur from my participation in such programs and activities. In the event of injury due to participation, I agree to release and hold harmless the Borough of South River, the South River Department of Parks and Recreation, its supervisors, employees, and all volunteers as well as other persons connected with the Borough of South River from all liability relating to personal injury or property damage that I may sustain as may be within the immunities provided to the Borough of South River pursuant to the New Jersey Tort Claims Act.
I also understand that I am to conduct myself in an acceptable manner at all times. If for any reason I conduct myself in an unsportsmanlike manner or cause harm to or disrupt an activity, in that event it shall be at the discretion of the coach, director, and/or supervisor of said activity to eject me from the above referenced activity with no further liability inuring to the Parks and Recreation Department. If I have paid a fee for any sport or activity and I am ejected, I understand that the fee shall be non-refundable.
*Please review your application before submitting for payment.*
Step 8: Payment
Amount Due