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Dodgeball Blast
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Dodgeball Blast on January 19, 2026
Come compete with and against other in this Dodgeball Blast Game for grades K-8th on Jan. 19, 2026 starting at 1pm in the Middle School Gym. Enter CIMS through the South Door #8. All are welcome and kids will play against similarly aged children.
Child's Name
*
First
Last
Select Child's Grade Division
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Select Child's Dismissal Option
*
Walk home
Walk to car
Parent will come in for pick up
Parent/Guardian Name
*
First
Last
Parent/Guardian Work Phone Number
*
Parent/Guardian Phone Number
*
Permission for Photos to be taken?
Yes
No
Parent/Guardian Email
*
Others allowed to pick up your child? Please state below their name & relationship.
Address
*
Street Address
Address Line 2
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Participation Waiver
*
I agree to the participation waiver.
We, or I, as parent and/or legal guardians of the participant named above, herby give consent for my child to participate in this program and all other activities incidental thereto, including practice, actual participation, being a spectator thereto, and any incidental travel connected with the activity. I further agree to assume full responsibility in case of any accidental injury incurred while participating in this activity. By enrolling, I waive and release all rights and claims arising from this activity against the Clearwater Recreation Commission, the City of Clearwater, USD #264, its representatives, successors and coaches from injury, illness and accident resulting in participation in this program.
Parent/Guardian Signature
*
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