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2017 Summer Playground Registration

Online Registration Form

You can download a printable registration form here:

PDF Document2017 Summer Playground PDF
Already have an account with us? Login to your account to auto-fill this form (OPTIONAL) 
Registrant OPTIONAL: If you already have account with us, please log in and select your child's name from the picklist. After a name is selected, most of the form will be automatically filled in (Name, Resident, Birthdate, etc.)
Registration Information 

Please choose ONE park only. You can not register for more than 1 park.

Participant Information 

Please enter the birthdate using the following format MM/DD/YYYY

Please check the box on the left if your child has any medical condition(s) and list them in the space provided
Medical Conditions
If you do not live in Springettsbury, please choose Other in the drop-down below and enter your city in the space provided
Emergency Contact 
Guardian Type
Emergency Contact Phone Numbers 
Please list your phone numbers below in order of priority and choose the type of phone number in the corresponding drop-down to the right.  If you do not have an additional phone number to enter for Phone 2, please use the same number as Phone 1.
Phone 1 Type
Phone 2 Type
Phone 3 Type
Phone 4 Type
Waiver of Liability 

Waiver, Agreement and Refund Policy

Please read carefully

For many years, thousands of Springettsbury children have participated in a wide variety of fun and safe activities through the Township's Summer Playground Program. This ongoing summer recreation tradition for children ages 6 to 14 includes daily activities such as sports leagues, tournaments, crafts, trips, and special events. Trained staff encourages children to develop more positive use of their leisure time through activities that promote learning experiences and their physical and social development. As the number of children participating has increased, park locations and staff also have grown over the years. It has become increasingly difficult to maintain the program at its current level. The Summer Playground Program includes 9 park sites and 30 staff! We have carefully considered all options to maintain this excellent program at its current level. While recognizing costs and creating program sustainability, we have determined that implementing a registration fee will enable the summer recreation playground program to maintain the same high level of service without any reduction in staff or of any of the 9 playground sites. As a result, the registration fee for the 2017 Summer Playground Program has been established at $25 per child for residents and $30 per child for non-residents. This fee enables us to continue providing the same high quality, safe Summer Playground Program services you and your child have come to expect and rely on.

When registering your child, please understand that payment must be received with your registration form. Although registration will be accepted throughout the summer, we will no longer accept registration forms or payments at any of our park locations. The registration form and payment can be processed online at www.springettsbury.com or you can mail or drop off at the Township Municipal Building located at 1501 Mt. Zion Road. We are open Monday through Friday from 8 am to 5 pm. Registration information for the Summer Playground Program will be on our website in April. Additional information will follow in our summer newsletter in May. The registration fee will cover the various "drop in" services provided at each park location. Weekly field trips are optional and include an additional fee. Refunds will not be issued once the program starts. Please contact the Parks and Recreation Department at 717-505-0406 with any questions. We thank you in advance as we prepare to serve the children of Springettsbury this summer.

Waiver of Liability

I, the above named candidate for participation in the above named activity, hereby, waive any claim for bodily injury or property damage against the Springettsbury Township Parks and Recreation Department, its agents, servants and/or employees while a participant in the above named activity. I also permit the Springettsbury Township Parks and Recreation Department to use any photographs or videotape of me or my child(ren) for promotional purposes.

*Furthermore, I hereby grant permission for my child to participate in the Arts and Crafts and Sports Leagues and Tournaments sponsored by the Springettsbury Township Parks and Recreation Department. I understand that some of these activities involve van/bus transportation to and from the various playground sites.


By checking the boxes below, this will serve as the Participant's and Parent's Signature and as proof of reading and understanding the Waiver of Liability.



After submitting your Summer Playground Registration you will be required to pay the registration fee online using PayPal.
Springettsbury Township Residents - $25.00 per child
Non-Residents - $30.00 per child