Summer Family Fitness & Movie Night

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First NameRequired

Last NameRequired

Number of AttendeesRequired

Ages of ChildrenRequired-Separate ages with comma

Phone NumberRequired

Email AddressRequired

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T-Shirt (Youth) X-Small Small Medium Large

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Through entry in this event, I hereby release Navy Region Southwest Morale,Welfare & Recreation program and other sponsoring or co-sponsoring agencies or individuals, and their employees from responsibility for any injuries or damages I may suffer as a result of my participation in this event. I permit the use of my name and picture in broadcasts, newspapers, etc. As a participating attendee, I certify that all information provided on this form is true and complete.

Only submit registration for yourself. DO NOT sign up your entire command. All participants must submit their own event registration and agree to the release above.

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