Adult Enrollment Form

Ellinwood Recreation Commission
Please complete one form per person. You will have the opportunity to pay by credit card for appropriate registration fees at checkout. An email confirmation will be sent to your inbox after checkout and payment have been received, and we will try to email you a reminder before your activity starts! 
 
Please contact us with any additional questions:
Phone: 620-566-7323
Email: ellinwoodrec@gmail.com
Our office is located above Sunflower Bank in Ellinwood.
Mailing address is PO Box 342, Ellinwood, KS  67526.

Contact Information

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Activities Menu

Yoga
Days: Tuesdays & Thursdays @ 6:00 PM
Dates: 
Location: Lone Wolf Restuarant (Upstairs)
Cost: $30 Per 8-Week Session or $50 per 16-week session
$30 Class Fee + $1 Online Registration Fee
$50 Class Fee + Online Registration Fee

Instructor: Jaqcue Isern
Body Shape
Days: Tuesday & Thursday (5:30 am)
Dates: Sept 10 - Dec 10th
Location: High School Old Gym (Use South Doors)
Cost: $50 Per 16-Week Session + 1 enrollment fee

Instructor: Cari Ringwald

Release Form

I, the undersigned, hereby consent to myself/child enrolling and participating in all Ellinwood Recreation Commission activities. I acknowledge that the activities involved by their nature involve some inherent risk. I assume all physical risks and hazards involved in the conduction of recreational programs and hereby release, and hold harmless this organization and any other civic or private party organization involved in any way in the activity from any liability as a result of an accident which may occur in conjunction with said participation and the result of bodily injury to myself/child. This release is intended to include all individuals and representatives of the organizations and individuals and representatives participating in recreational programs. I further acknowledge and understand that no insurance is provided by the Ellinwood Recreation Commission, Kansas or any other organization or entity assisting with promoting or conducting the program, travel and activities.

I hereby give Ellinwood Recreation Commission permission to us my name/child’s name, my photography, and/or footage shot at recreational activities to be used in print advertising, broadcast advertising, and website advertising for the Ellinwood Recreation Commission. I waive rights to any and all payments concerning the use of my photographs and or audio video recordings.

By signing below you agree to both statements above:

Checkout & Payment

Current Total:
$0.00