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 $20 per family for a year of membership - from September to August. If you join or renew now, your membership will be valid through August 2010.

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:

Membership Directory

Yes, I'd like my name, email address, child(ren)'s first name and the year my child will begin Kindergarten listed in the LPA's new online, password protected, members-only directory.

Please choose a username and password for our members only area.

User Name:

Password:

Hold Harmless Agreement

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 par-ticular 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 as-sume 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 re-move myself from participation and bring such to the attention of the nearest Littleton Parents Rep-resentative 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 AGREE-MENT, 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 pro-grams 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, fundraising 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.