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February 9th, 2012
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Complete the form below to create an account for RPAY's Vegetable and Fruit Challenge!
Gender: Female
Male
Age Range: up to 12
13 to 18
19 to 30
31 to 54
55 + better
Do you have children under the age of 18 at home? Yes
No
Have you participated in RPAY's programs before? Yes
No
How did you find out about this program? From RPAY
Through an ad or poster
At work or school
Other:

Waiver

I agree that I (or my child ) am participating in the program at my own risk. I accept full responsibility for my own health and well-being. By signing below, I agree that to my knowledge I (or my child) have no limiting health conditions precluding participation. I understand that no responsibility is assumed by the Recreation and Parks Association of the Yukon (RPAY) or their funding agencies, and I release and discharge RPAY and their funding agencies from any and all liability for damage, loss, injury or expense that I (or my child) may suffer or incur as a result of my participation.

  I have read and fully understand and agree to the above statements.
 
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