Illinois River Valley Special Recreation Association - 2025 SVT Registration Form

2025 Recreation Team Registration

(6 V 6)

No upcoming class

Saturday 8:00 AM - 4:00 PM

September 13, 2025

$240

Mineral Springs Park

1701 Court Street, Pekin, IL 61554

Mineral Springs Park

1701 Court Street, Pekin, IL 61554

Registrations ended on September 1, 2025 11:59 PM.

Team Captain

You will receive your registration confirmation by email. If you, the team captain, are also a player on your team, be sure to list yourself again on the player roster. Team captains do not have to play.

First name *

Last name *

Email *

Mobile

Player 1

First name *

Last name *

Email

Mobile

Gender *

Player 2

First name *

Last name *

Email

Mobile

Gender *

Player 3

First name *

Last name *

Email

Mobile

Gender *

Player 4

First name *

Last name *

Email

Mobile

Gender *

Player 5

First name *

Last name *

Email

Mobile

Gender *

Player 6

First name *

Last name *

Email

Mobile

Gender *

Assumption of Risk and Waiver of Liability:

I understand and acknowledge that my enrollment to participate in Activity is wholly voluntary and that there are physical risks and hazards connected with participation, including, but not limited to the risk of communicable disease such as COVID-19. I understand, acknowledge, and agree that IRVSRA, Fon du Lac Park District, Tazewell County Veteran’s Memorial Fair Association, nor Pekin Park District is not responsible for and does not assume the costs of any medical testing, care, or treatment associated with the Minor’s participation in the Activity, including, but not limited to, any medical testing, care, and treatment of the Minor or anyone with whom the Minor may have contact during or after the Minor’s participation in the Activity.

I agree, on my own behalf, on behalf of Minor, and on behalf of others acting on my behalf to comply with all Pekin Park District’s rules and regulations regarding Minor’s participation in the Activity, including all rules and regulation. I understand and agree that noncompliance with any such rules and regulations by myself, Minor, or anyone acting on my behalf may result in termination of Minor’s participation in the Activity.
Having been given sufficient time to read and review the above acknowledgments, understandings, and agreements, I hereby consent to the Minor’s participation in the Activity.

I voluntarily agree to assume all risks, known and unknown, and accept sole responsibility for any injury to Minor, myself, or others with whom we may come into contact, including, but not limited to personal injury, disability, death, illness, damage, loss, claim, liability, or expense, of any kind, that I, Minor, or others who may come into contact with us may experience or incur in connection with Minor’s participation in the Activity. On my behalf, and on behalf of Minor, our heirs, and our legal representatives, I hereby release, covenant not to sue, discharge, and hold harmless IRVSRA, Fon du Lac Park District, Tazewell County Veteran’s Memorial Fair Association, Pekin Park District, its successors, assigns, employees, Board members, officers, officials, administrators, agents, and volunteers from any and all claims, causes of action, suits, expenses, debts, accounts, controversies, damages, claims and demands arising out of the Minor’s participation in the Activity.
I consent to photos and or videos taken during an IRVSRA program, containing this/these minor(s), and acknowledge they may be used on social media outlets, printings, publication, and future marketing materials for IRVSRA or Pekin Park District.

I hereby acknowledge that I have read this Parental/Legal Guardian Waiver, Release, and Assumption of the Risk, I understand the same, and I have voluntarily agreed to these terms.

I read and accept *

Please read and scroll to the bottom to accept.

Electronic signature*

Please sign your name inside the box

Draw Type

×