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Lego Spring.pdf
LEGO Engineering Registration:
To register, fill out this form and mail it or drop it off at Rutland Recreation (250 Main Street,
Rutland MA 01543) before March 10 for Engineering FUNdamentals or before April 21 for
Pre-Engineering. Call 508-886-0048 with registration questions.
Please to not send forms to the school. Make checks payable to “utland Recreation”Confirmations are not sent. Please send a note to your child’ homeroom teacher making
them aware of their participation. Transportation will not be provided.
Student’ Name: ___________________________________ Age: _____ Grade: _____
Parent’ Name: _________________________________________________________
Home Phone: _______________________ Cell/Work Phone: ____________________
Email: ________________________________________________________________
Medical Considerations: __________________________________________________
Teacher: _________________________ Naquag                               Glenwood
Program Name/Day: _______________________________________ Fee: $________
I agree not to hold responsible the Rutland Recreation Commission; the Town of Rutland; the owners of
the premises where the program is held; or any parties connected with the program for any injury or
accident that may occur during the program. No money will be refunded. I also grant permission for the
Recreation Staff to seek medical care for my child in event that a family member cannot be reached. (All
participants in any town program must complete this waiver.)
Signature:______________________________________________Date:___________


 
Town of Rutland 250 Main Street, Rutland, MA 01543   Disclaimer
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