Town of Kinderhook Recreation Commission
2008 Summer Program Schedule (6/10-10/18)
Program Location Ages Dates Time Fee
Swimming (Session 1) Knickerbocker Lake 3 yrs. 7/07-7/18 Mornings $20 per
(Session 2) & up 7/21-8/01 Mon - Fri
Session
(Session 3) 8/04-8/15 Times TBA
Summer Swim Permit Knickerbocker Lake All 6/20-8/17 12pm-7pm $35 / resident
Daily
$60 / non-res.
Tennis Instruction Town Park Courts Grade* 7/07-8/15 830-930am $20
Niverville 6-12 Mon – Fri
Recreational Tennis Town Park Courts 8 yrs 7/07-8/15 945-1045am $20
Niverville & up Mon - Fri
Kickball League Volunteers’ Park Grade* 7/07-8/11 630-730pm $10
(State Farm Road) K-2 Mondays
Kickball League Volunteers’ Park Grade* 7/07-8/11 630-730pm $10
(State Farm Road) 3-5 Tuesdays
Adult Volleyball Volunteers’ Park 14 yrs 6/10-8/28 600 – Dark $20
(State Farm Road) & Up Tues & Thurs
5K Fun Run K’hook Village Square All 6/18-8/20 Weds.-700pm Free
Karate Martin H. Glynn 5 yrs. 7/09-8/13 1230-130pm $20
& up Wednesdays
Adult Basketball Volunteers’ Park 18 & up 7/07-8/13 600-800pm $160
(State Farm Road) Mon & Wed /team
Youth Basketball Volunteers’ Park Grade* 7/08-8/14 600-800pm Free
(State Farm Road) 6-12 Tues & Thurs
Playground Volunteers’ Park Grade* 7/07-8/15 900-300pm $25 /six weeks 1
(State Farm Road) K-8 Mon - Fri
Introduction to Horses Volunteers’ Park 12 & Up 7/11-8/01 310-430pm $75 / resident
Riding & Driving (State Farm Road) 6 & Up/with Fridays $100 / non-res.
Adult
Fall Soccer Volunteers’ Park Grade* 9/13-10/18 830 – 12pm $10 2
(State Farm Road) K-8 Every Sat.
MAIL REGISTRATIONS TO: T.O.K. REC. Box P, Niverville, N.Y. 12130
Make check payable to: Town of Kinderhook Rec. Comm.
* Refers to the grade student will be in this Fall (2008)
1 Playground fees: Non Res. I.C.C. Student-$25/week; Other Non Res. - $50/week; Stuyvesant residents apply through Town of Stuyvesant
(Transportation provided from Callan Park and Town Hall to Volunteers’ Park 9 am returning 3 pm)
2 Early registration fee; $20.00 in September 2008
Soccer registration - Sept. 3, ‘08 @ Spruce Bldg. Volunteers’ Park from 6 pm - 8 pm.
Written notes required for children riding bikes or riding with a non parent
For more information Call: (518) 758-9754
______________________________________________________________________________________________________________________
REGISTRATION FORM (for Playground and all programs)
ONLY ONE NAME PER REGISTRATION
Name__________________________________ Sex _____________ Birth Date _____________ Grade Entering __________
Mother’s Name________________________________ Phone (H) ____________________ (W) ________________________
Father’s Name__________________________________ Phone (H) ____________________ (W) _______________________
911 Address____________________________________________________________________________________________
Street & number City State Zip
If parent not available in an emergency notify:
Name______________________________________________________________Phone______________________________
911 Address____________________________________________________________________________________________
Health History: (Check)
Rheumatic Fever _______ Convulsions ________ Diabetes _______ Hay Fever ________Allergies _______ Asthma _______
Other diseases, problems & or details of above: ______________________________________________________________________________________________________
Immunizations: This form can not be processed without valid dates.
Polio _______________________ DPT ____________________ Tetanus __________________ MMR __________________
Haemophilus Influenza Type B _______________Hepatitis B______________ Varicella (Chicken Pox) __________________
IMPORTANT: Please notify program director if your child is exposed to any communicable disease during Summer or Fall Program.
Name of family physician or health care facility used by your family:
______________________________________________________________________________________________________
In the event of injury, the Town of Kinderhook and staff are not responsible for any accident or medical expense incurred. As parent or guardian I am responsible for any medical expense.
Parent/Guardian
Signature________________________________________________________Date__________________________________
Check any of the below activities your child plans to participate in:
Swimming Lessons - Session 1________ Session 2________ Session 3________ Swim Permit_________ Karate __________
Tennis Instruction______ Recreational Tennis_______ K-2 Kickball _______ 3-5 Kickball _________ Volleyball __________
Adult Basketball ________ Youth Basketball ________ 5K Fun Run _______ Fall Soccer_________ Playground __________
Introduction to Horses: Riding and Driving ________
* Circle these activities if a member of your family is able to coach.
Cost for child: _______________________________ Total cost for family_____________________________
(WRITE ONE CHECK FOR ENTIRE FAMILY)
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