Welcome to the Derby Recreation Commission website. Please check back here for updates due to weather or other program changes.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
Event Date: Sunday, August 7, 7am
Cost: $40 by 7/28/11
Cost:$45 on or after 7/29/11
Registration Deadline 8/3 at 10pm
 
Name
 
Address
City/Zip
Phone Home                          Phone Work
Email
   Female      Male
Date of Birth (Month/Day/Year)
USAT Member Yes No ($10 Single Day Membership Required and will be processed with below credit card)
Expiration Date of Membership (if checked Yes)
 
 
Shirt Size
  S     M   L     XL  
 
Estimated 400 meter swim time(min)(sec)
 
Waiver for Participant
In consideration of your accepting this entry, I hereby, for myself, and child, my heirs, executors and administrators, waive and release any and all rights and claims for damages I or my child may have against the Derby Recreation Commission, City of Derby or USD 260, and its representatives, successors and assigns for any and all injuries suffered by myself or my child at any activity sponsored by these groups. Parent or Legal Guardian must check for any child under 18.
agree     disagree
 
 Payment method  Mastercard      Visa
Credit Card #
Credit card Exp. Date