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Steve Fifer, Frankfort Square Park District mechanic is a member of an Elvis back-up band, and travels throughout the United States and Canada performing at various events.

Administration Building
7540 West Braemar Lane
Frankfort IL 60423
Phone: (815) 469-3524
Fax: (815) 469-8657
email: info@fspd.org

Office Hours
Mon, Tues, Thurs: 9 am - 5 pm
Wed & Sat: 9 am - 12 pm (noon)
Fri: 9 am - 4 pm

FILLING OUT THIS FORM DOES NOT REGISTER YOU FOR THE PROGRAM. YOU MUST GO THROUGH THE ONLINE REGISTRATION PROCESS TO GUARANTEE REGISTRATION.

(Please provide all information below. Missing information could delay processing!)

Participant First Name:
Participant Last Name:
  Gender: male female
Mom's Name:
Dad's Name:
  Address:
  City:
  State:
  Zip:
  Home Phone:
  Mom's Business Phone:
  Dad's Business Phone:
  Birthdate (MM/DD/YY):
  Grade (as of current school year):
  Shirt Size (shirts run small):
  Shirt Received? yes no
  If you already have a shirt enter the number here:
IMPORTANT!!! IN ORDER TO PROPERLY DIVIDE TEAMS, ALL PREVIOUS EXPERIENCE MUST BE LISTED BELOW.
  How many years basketball experience do you have?
  Did you play in the park district basketball league last year? Yes No
  Did you play on the school's basketball team ? Yes No
  Is there any physical problem that the player’s coach should be aware of? (if Yes please explain below.) Yes No
 

VOLUNTEERS:
This program is only possible through support of volunteers. CHECKING A SPECIFIC AREA, DOES NOT GUARANTEE A COACHING OR ASSISTANT COACHING POSITION. If the Park District is unable to secure coaches, we reserve the right to limit registration.

Would you be able to volunteer? Yes No
(if yes please select one or more options below)

Coach Assistant Coach

LIABILITY WAIVER:
Participants in Frankfort Square Park District activities are not covered by medical or accident insurance. Each particpant must furnish his/her own personal coverage. Many sports activities and programs have inherent elements of danger. Participant or parent permission is needed to call an ambulance in an emergency. As a participant (or as a parent of a participant under 18 years of age), I hereby agree to save harmless and indemnify the Frankfort Square Park District, its trustees and employees from any responsibility for any accident, injury or damage that may occur as a result of the participant’s acts or omissions. In case of accident or sickness, I consent to emergency medical care provided by ambulance or hospital personnel.

By clicking the Submit button below you are agreeing to this Liability Waiver.

 
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