2023 Water Aerobics Registration 2023 Water Aerobics Registration Name First Last Primary Contact Phone* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Residential Status*Please Choose...Resident of MonticelloNot a Resident of MonticelloA resident is any individual who resides within the village limits AND pays Monticello taxes. All other individuals living outside the village limits are considered non-residents with taxes being paid to the township.Water Fitness Class (Resident)Please Choose...Session 1: Water Fitness Class $40Session 2: Water Fitness Class $40Both Sessions: Water Fitness Class $80Number of ParticipantsPlease enter a number from 1 to 7.1st Participant's Name 2nd Participant's Name 3rd Participant's Name 4th Participant's Name 5th Participant's Name 6th Participant's Name 7th Participant's Name Water Fitness Class (Non-Resident)Please Choose...Session 1: Water Fitness Class $50Session 2: Water Fitness Class $50Both Sessions: Water Fitness Class $100Number of ParticipantsPlease enter a number from 1 to 7.1st Participant's Name 2nd Participant's Name 3rd Participant's Name 4th Participant's Name 5th Participant's Name 6th Participant's Name 7th Participant's Name Terms and ConditionsPlease be aware the Recreation programs involve an element of risk or danger for all participants and may cause serious injury or property loss. The Recreation Department does not provide nor cover any medical or hospital insurance for participants in our program. Anyone participating in sponsored programs assumes risk of all injuries. In order to participate, an adult signature is REQUIRED. I have read and agree to the terms above* Check box for signature Total Pool FeesTotal $0.00 Registration SubmissionCaptchaEmailThis field is for validation purposes and should be left unchanged.
