320 North Main Street Slippery Rock, PA 16057 Monday – Friday 8:00am-3:30pm
playsafe@srpark.org
724-794-8180
Toggle navigation
Welcome
Board of Directors
Meeting Dates
Park Attractions
Walking Trail Map
Walking Trail
Preschool
FLF Program
Pre-K Program
Tiny Minds
Tiny Tots
Preschool Registration
Playsafe
PlaySafe Registration
PlaySafe Scheduling
Sports
Swim Lessons
Swim Waiver
Fall Soccer
Gymnastics
Skiing
Activities
Additional Programs
Breakfast with Santa
Scholarships
Rentals
Recreation Center
Pavilions
Contact
Donations
Summer Playsafe
Home
Summer Playsafe
Child's Name
Age
Please list an medical concerns or food allergies.
T-shirt Size
Second Child's Name
Child # 2 Age
Child #2 T-shirt Size
Please list an medical concerns or food allergies.
Mother/Legal Guardian Name
Mother/Legal Guardian Address:
Mother Phone/cell number
Mother E-Mail:
Father/Legal Guardian Name
Father/Legal Guardian Address:
Father Cell phone:
Father E-mail:
Please list at least two names, besides yourself, whom you authorize to pick-up your child.
1. Name:
2. Name:
Names of emergency contact, if parent is unavailable:
1. Full Name and Number
2. Full Name and Number
The Park will not be responsible for any toys, hand held games or personal belongings your child/children brings to PlaySafe.
My child/children and I agree to abide by the Park's rules and regulations in order to maintain the safety and security of this program.
Archives