Paint by the Glass Here is your opportunity to create a unique piece of art that you can cherish for years to come, or give as a unique gift. Join Sooo Chic Designs and the Clinton Parks and Recreation Department for a wine glass painting class. Our instructor will walk you through creating this unique piece of art. The more the merrier, as this is a social class designed to engage the participants, so don’t be shy about inviting friends! We are offering two separte classes over the winter. All supplies included, participants will decorate 1 wine glass. Please check the box next to the class you are interested in attending. Date 18th, Friday, January 2015 Sunday, February 8th, 2015 Time Cost Location 6:00pm8:00pm 1:00pm3:00pm $35.00 Clinton Parks and Recreation Department Clinton Parks and Recreation Department $35.00 To register: Please complete this registration form and mail it in with payment. Checks may be made payable to the “Town of Clinton” and sent to Parks & recreation, 560 High Street, Clinton MA 01510 Let’s Pinterest Class Name: _________________________________________________________________________ DOB: _______________________ (Please Print) Address: _______________________________________________________________________________________________________ E-mail: _____________________________________________ Phone: ___________________________________ Emergency Contact: ____________________________________ PHONE________________________ I give Clinton Parks & Recreation permission to use pictures taken during the program on their website and in promotional materials. Injury Waiver: In consideration of participation of the minor player named above in this recreation program, the undersigned hereby consents to his/her participation and releases and holds harmless the Town of Clinton and the Clinton School District and their officers, agents, and employees from any liability for, and waives all claims, suits, or causes for action that the undersigned, as parent or guardian, and said m inor, either before or after he/she may reach his/her age of majority, may have now or hereafter based on or arising from, any injury suffered or incurred by the minor player as a result of, or in conjunction with, his/her participation in said recreation program. Such waiver and release to be in effect without regard to whether such injury is the result of or caused by the fault of the town of Clinton or the Clinton School District or any of their officers, agents, or employees. This instrument is intended to take effect as a sealed instrument. I further certify that I/ my child is medically fit to participate in the above recreation program. Signature: _____________________________________________________ Date: ___________________________