HomeMy WebLinkAbout304351 10/26/16 CITY OF CARMEL, INDIANA VENDOR: 371262
ONE CIVIC SQUARE SARAH BLAIR CHECK AMOUNT: $......«.16.00
CARMEL, INDIANA 46032 3910 CHANCELLORS CT CHECK NUMBER: 304351
WESTFIELD IN 46062 CHECK DATE: 10/26/16
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT I DESCRIPTION
REFUNDS AWARDS & INDE
1096 4358400 2001489003 16.00
Voucher No. Warrant No.
Blair, Sarah Allowed 20
3910 Chancellors Ct
Westfield, IN 46062
In Sum of$
$ 16.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-10 2001489003 4358400 $ 16.00 1 hereby certify that the attached invoice(s), or
bill(s) is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
October 19, 2016
Signature
$ 16.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
10N7/2016 Receipt#200489.00
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~Community Center East Building Ito
1235 Central Park Dr. East ~~---------------------
Carmel, IN46O32
Phone: (317) 848-727�
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FAX: — Carme � �� �� _ ��-�� -��- �==�yEnnai|: infu��carnne|dayparks.corn
Parks&
Recreation
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Prepared Bv: |e8hvv
Customer ID: 29793
Primary phone: (954) 410-4739, Secondary phone: —
Total Received: ($1600) Total Refund: ($16.00)
Delaney Stair Learn mSwim Level 4: Swim Lessons#za»om'oz Activity Fee each 1.00 $65.00 ($as.00)
1zvzsUnion Spring Action:Transfer Out
#2A Withdrawal Date: Oct o'mzo
Ca""°/'IN 46032
Primary phone: (9s4)4m'4r3y Meets: From September r'zozotoSeptember zo'znzo
sm"//. �m2674@v"x""'com Each Wednesday from snmto szspm .'
ID: 29996 u,,auun: Indoor Lap Pool
Delaney Blair Learn to Swim Level 4: Swim Lessons#263010-09 Activity pee Per Seat 1.00 $49.00 $49.00
zzy25Union Spring Action:Transfer m
#z^ Enrollment Effective Date: Oct 1r'zozo
Carmel,/m^m»z
Primary phone: (o5*)4m-wso Meets: From November z'znzamNovember 1*'zozo
s="n. s*12674@,°^^".m= Each Wednesday from spmcn s:ssnm
ID: 29996 Location: Indoor Lap Pool
l[mtaU Charges ($16.00)
Total Payments � 15.00
'
Balance $U
Activity Waiver
VVaiver for:De\aney Blair
Carmel Clay Parks & Recreation Waiver and Release ^ �
On my behalf and on behalf of my heirs and assigns, l HEREBY RELEASE, WAIVE, DISCHARGE,
COVENANT NOT TO SUE AND AGREE TO HOLD HARMLESS THE CARMEL/CLAY BOARD OF PARKS AND
RECREATION, CARMEL CLAY PARKS & RECREATION/ CITY OF CARMEL, CLAY TOWNSHIP, ITS AND THEIR
OFFICIALS, OFFICERS, PASSHOLOERS, INDEPENDENT CONTRACTORS, EMPLOYEES AND VOLUNTEERS
/the ?Releasees?), from any and all claims or liability for personal injury or property damage my child
'nd/or I may cause or suffer directly or indirectly arising out of or relating in any respect to
participation in program, event, service or facility provided by or made available through Carmel Clay
Parks & Recreation. This waiver and release of all claims, demands, actions, and liability shall include,
without limitations, any injury, damage or loss to person or property which C may be `(a'l caused b y any
act, or failure to act, by Releasees even if said injury, damage or loss results from the negligence of
any or all of the above-identified Releasees or (b) sustained by me during and/or at the Carmel Clay
ParkS & Recreation program, event, service or facility in which l and/or my child participate(s).
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