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Community Center/Senior Program Annual Registration

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    1. LBTS_LogoLongBlocks (1)
    2. Community Center/Senior Program

      Annual Registration

      October 1, 2021 - September 30, 2022

    3. IMPORTANT: PLEASE READ AND SIGN

      WAIVER FOR PROGRAM PARTICIPANTS: I do hereby INDEMNIFY and HOLD HARMLESS the Town of Lauderdale-By-The-Sea (LBTS), its officers, agents, staff, representatives, executors and all others from any and all responsibilities or liability from injuries or damages arising out of or in any way connected with my participation in the Program and any activity on Town property. I hereby indemnify and hold harmless all the aforementioned and others acting upon their behalf from responsibility or liability for any injury and damage to myself including any caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected to my participation in any activities at the Town of Lauderdale-By-the-Sea facility. I have carefully read this release in its entirety, fully understand the contents thereof and by execution below, expressly agree to be bound by its terms and conditions.

      I have read and agree to the LBTS liability waiver. I acknowledge that the Town is relying on my representations in this registration to determine eligibility for the program. By signing below, I certify that the information contained in this registration is true, complete and accurate to the best of my knowledge. Should any of the representations made herein change, I hereby acknowledge my obligation to immediately notify the Town and update those representations.