2025 Primetime Events for Teens Registration Form

Prime Time Teen Registration Form
Please Complete Registration
Name*

First NameLast Name
Grade*
Age*
School Name*
Your Email*
example@example.com
Your Phone Number*
Please enter a valid phone number.
Parent/Guardian Name*
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Email Adress*
example@example.com
Which Primetime Event will you be attending?*

Dive In Movie: Friday, June 20 8:00 pm - 11:00 pmMidnight Hoops: Friday, July 25 9:00 pm - 1:00 amI will attend both events
I hereby give my permission for my son/daughter to attend the City of Columbia Parks and Recreation Primetime Events on June 20, 2025, and/or July 25, 2025

Release of Liability

In consideration of the events and facilities provided by the City of Columbia, its employees, agents, sponsors and officers, I hereby release and forever discharge the aforementioned from any and all liability arising out of my child’s participation in the or travel to and from the events.

I am fully aware of the risks inherent to these activities and will not allow my son/daughter to participate unless medically able to participate. I assume all risk associated with my son/daughter participation in this activity.

I agree that photographs, recordings, or any other record may be collected and used for the purpose of administering and promoting programs operated or sponsored by the City of Columbia.

In case of accident or illness, I authorize a representative of the City of Columbia to obtain immediate care for my child. I have read and fully understand these terms are contractual, not a mere recital, and sign it voluntarily.
I agreeI DO NOT Agree
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Prime Time Teen Registration Form

Please Complete Registration