EB2Gov POS

PLYMOUTH REC VAN TRIPS

Tuesday, November 25th 6-9:30pm

Wicked: For Good (2025) - IMDb

Saturday, November 29th 3-7pm

PLYMOUTH REC VAN TRIPS

Tuesday, November 25th 6-9:30pm

Wicked: For Good (2025) - IMDb

Saturday, November 29th 3-7pm

Van Trips 2025

Full Name:

Date of Birth:

Cell Number:

Address:

Allergies or Limitations:

Select Trip:

Full Name:

Date of Birth:

Cell Number:

Allergies or Limitations:

Select Trip:

Full Name:

Date of Birth:

Cell Number:

Allergies or Limitations:

Select Trip:

Name:

Phone Number:

Amount:

EB2Gov Fee:

Quantity:

Payment Amount:

Notes:

I have opened and viewed this program manual:

CLICK HERE - Programs, Special Events & Trips Manual

PLEASE READ AND CHECK THE BOX TO ACKNOWLEGE THE RELEASE OF ALL CLAIMS: In consideration of the permission granted for the participant named above to take part in the above named Recreation program, I hereby release for myself and my heirs, the Town of Plymouth, its agents, employees, volunteers and other program participants from all actions, damages and claims that may result in personal injuries and property damages. I recognize there may be inherent dangers in participating in Recreation programs which may present a strain on the body and its parts, and furthermore, I represent that to the best of my knowledge the participant is in proper physical condition to allow participation. I therefore assume all risks associated with participation in said program. I understand that, in case of injury or illness, the Recreation department will attempt to contact the parent/guardian listed above. In the event of a medical emergency, I consent to the participant’s treatment by a medical doctor and I agree to pay all costs associated with said treatment, including transportation to a medical facility. I, the undersigned, have read this release and understand all its terms and implications and I hereby execute this release of my own free will and with full knowledge of its significance.

Guest #1

Guest #2

Guest #3

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