superstar sports application tenafly

[Guest guest]

Dear Parents, Professionals and Friends,

Attached is the application for the Superstar Sports class which begins on

Wednesday Oct. 14th from 5PM-6PM in Tenafly. The class is for students ages

5-21 and their siblings or parents as " buddies " under my direction.

During the first class, NY1 will be filming to do a special story on us. If

anyone has an issue with this please let me know so I can tell them to make

sure to edit your child out of the video footage.

This class is truly my pleasure to teach and I look forward to seeing you

then. Please feel free to distribute this flyer. If necessary, we may make

a second class so that I can personally give your children the attention

they need. Please call me at the # below if you have any questions.

Suzanne M. Schwarz

ourchildrencanlearn.com

201-220-6865

SUPERSTAR SPORTS APPLICATION

Tenafly Recreation presents a program for special people!

A non-competitive sports program in which children learn adaptive physical

education skills! Sessions will combine a variety of physical education

games and sports instructed by certified Physical Education and Special

Education teachers. The program will focus on motor skill development and is

open to children ages 5-21 of all ability levels. A parent/caregiver wil be

required to attend and participate in this cooperative learning process.

PROGRAM DATES BEGINS ON OCTOBER 14

PROGRAM MEETS ON WEDNESDAYS

(8 SESSIONS)

TIME 5:00PM-6:00PM

LOCATION To be Announced

please contact tenefly recreation 201-871-3008 for details

Instructed by McIntosh, Physical Education Teacher

Suzanne Schwarz, Special Education Teacher

Fee $60.00

Please make checks payable to Tenafly Recreation,

Return to 100 Riveredge Road, Tenafly, NJ 07670

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CHILDS NAME___________________________ GRADE_________

DATE OF BIRTH_______________

ADDRESS____________________________

PHONE (H)___________________________

(ALT)________________

(EMAIL)__________________________

EMERGENCY CONTACT_________________________ PHONE_______________________

DOCTOR_____________________ PHONE__________________ SPECIAL MEDICAL

INFORMATION_________________________

_______________________________________________

I the undersigned parent/guardian of the above named applicant do hereby

give my permission for him/her to participate in this specific Tenafly

Recreation Commission activity.

I do assume all risk and hazards incidental to this trip, activity and

transportation and do further hereby release, absolve and hold harmless the

Borough of Tenefly, Tenafly Recreation Commission, its agents, instructors,

and coaches.

I do further understand the the Borough of Tenafly or the Tenafly Recreation

Comission does not provide Accident Insurance for this activity.

I hereby fully concent to emergency medical care to be rendered by competent

medical physicians in the event that the above named child should require

such attention during this activity.

PARENTS NAME________________________________

SIGNATURE___________________________

CHECK#___________FEE$________

RECEIPT#___________________

DATE______________________