Membership

LPA membership allows your entire family access to LPA sponsored events throughout the year as well as a copy of our monthly eNews. Our membership fee is $15 per family for a year of membership - from September to August. If you join or renew now, your membership will be valid through August 2009.

If you would like to learn more please e-mail our Membership Coordinator.

The LPA is affiliated with First Connections and the Justice Resource Institute. If you would like more information about First Connections, please check the box on the form to sign up for their newsletter.

To sign up or renew your membership, please complete the form below. Current members, please e-mail our Membership Coordinator if you need to update your contact information, especially if you have changed your e-mail address.

What would you like to do?

New Member Sign Up Renew current membership

Tell us how to get in touch with you:

	* required fields
Name *
Street Address *
City *
State *
ZIP Code *
E-mail *
Telephone *

Children's Information:

First Child:
Name: *
Birthdate: *
Second Child:
Name:
Birthdate:
Third Child:
Name:
Birthdate:
Fourth Child:
Name:
Birthdate:
Fifth Child:
Name:
Birthdate:
Membership Directory Yes, please include my name, e-mail address and child(ren)'s name(s) and age(s) in the LPA Membership Directory available to all members by e-mail, mail, and/or password protected webpage.
Members Only Web Area Please choose a username and password for our members only area. (Coming Soon!)
User Name:
Password:

General Volunteering Opportunities:

I would like to help plan an event.

I would like to provide refreshments for an event.

I would like to help prepare crafts for an event.

Playgroups

Please check which playgroup(s) you are interested in and when you are available below. Please note that if your availability is limited, we may not be able to place you in a playgroup at this time.

Playgroup(s) Requested:

Infant I (0 - 6 months)	Infant II (6 - 12 months)
Toddler I (12 - 18 months)	Toddler II (18 - 24 months)
Toddler III (2 - 3 years)	Preschooler I (3 - 4 years)
Preschooler II (4 - 5 years)	Kindergarten (5 - 6 years)
Working Mom's Playgroup (multiage)

Your Availability:
Monday AM PM	Tuesday AM PM
Wednesday AM PM	Thursday AM PM
Friday AM PM	Weekends AM PM

Hold Harmless Agreement

LITTLETON PARENTS ASSOCIATION

LITTLETON PARENTS ASSOCIATION
HOLD HARMLESS AGREEMENT

In consideration of being allowed to participate in any way in Littleton Parents Association activities and related events, the undersigned acknowledges, appreciates and agrees that:

1. The risk of injury from the activities involved in this program may be significant and while particular rules, equipment and personal discipline may reduce the risk, the risk of serious injury does exist, and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, and assume full responsibility for my participation; and;

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest Littleton Parents Representative immediately; and

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS, Littleton Parents Association, First Connections, and the Justice Resource Institute, its officers, officials, agents, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property; and

5. In the event that a claim is brought by Participant or Releasee against the other, the defendant shall be able to recover reasonable attorney's fees if incurred in successfully defending against such claim.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

This is to certify that I, as parent/guardian with legal responsibility for this participant(s) do consent and agree to his/her/their release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's/children's involvement or participation in these programs as provided above.

* I consent and agree to the above Hold Harmless Agreement.

Publicity Release Permission

* Yes No I hereby give permission for my child's photograph to be used in publicity for the purpose of advertisements for the LPA, public relations for the LPA, fund-raising events for the LPA, or display on the LPA's website. These publications will not under any circumstances reveal the personal information of our members, unless the parent approves the verbiage prior to publication.

We welcome your ideas and comments:

How do you plan to pay your dues?

I will use the PayPal link on the next page.

I will mail a check to LPA, P.O. Box 504, Littleton, MA 01460.

I would like to apply for a financial hardship scholarship.

Please sign me up to receive the free First Connections Quarterly newsletter

Copyright 2007 Littleton Parents Association.
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Read our Disclaimer.

Last updated: 12/09/2007

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