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Above the Limits Registration Form

  1. The City of Fontana Community Services Department’s comprehensive Special Needs Program Above the Limits includes social-recreational, resource and referral, and inclusion support provided to the Fontana community. This form is used as a way to collect information about our Above the Limits member. Contact the Heritage Neighborhood Center at 909-349-6968 or the Cypress Neighborhood Center 909-349-6988 for information regarding Above the Limits upcoming events and program highlights.

  2. Above the Limit Participant's Information

  3. Emergency Contact Information

  4. Additional Information

  5. Release of Liability & Assumption Risk

    I, on behalf of myself or on behalf of my minor child, hereby waive in advance any and all actions or causes of action and claims for injury or property damage which I may have, or which may hereafter accrue to me, my heirs or other successors as a result of my participation in any activity, or activities incidental thereto, (hereinafter referred to as the “activity”) sponsored by the City of Fontana. This is intended to release and hold harmless the City of Fontana and it’s elected officials, officers, employees, contractors and agents.

  6. I understand that I must be in good health prior to participating in the activity. I understand that serious accidents occasionally occur to participants during such an activity, transportation to or from such an activity, and during activities incidental to such an activity. Knowing these risks, I expressly assume those risks and agree that under no circumstances will I, or any of my heirs or successors present any claim or action against the City of Fontana.

  7. I also agree to be photographed and or filmed, and or agree to have my child photographed and or filmed, and release the use of the photographs and or footage for publicity in City of Fontana publications and other public information materials.

  8. I hereby represent that I understand and am familiar with the nature of the activities in which I (or my child) will participate in this recreation program. I personally read and understand this release.

  9. Agree to the terms of Release of Liability & Assumption of Risk*

  10. Leave This Blank:

  11. This field is not part of the form submission.