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Registration Form Figure and Power Skating
 
Download our PDF: Registration Form or complete the below online form.
All payments are due within 10 business days of online registration. Please mail cheques to SK8 Georgian Bay or contact Jan Hulme for Visa or Mastercard transactions.

 

MAIN CONTACT    
Adult/Parent/Guardian's LAST Name
 
First Name(s)
 
Family Address
 
City
 
Postal Code
 
Home Phone Number
 
E-mail Address
 
Emergency Contact - Name and telephone number
 
   
     
SKATER #1 INFORMATION    
Family Name
 
First Name
 
Birthdate M/D/Y
 
Last level completed
 
Coach
 
Skate Canada #
 
Home Club #
 
     
MEDICAL INFORMATION    
Special Conditions/Needs:
 
Health Card #
 
Family Doctor
 
Allergies
 
     
SIGN ME UP FOR:    
Program Name
 
Session Code
 
   
FIGURE SKATERS ONLY
  Monday Tuesday Wednesday

Thursday Friday Saturday Sunday

     
   
(if more than one program) - Program Name
 
Session Code
 
   
FIGURE SKATERS ONLY
  Monday Tuesday Wednesday
Thursday Friday Saturday Sunday
     
   
(if more than one program) - Program Name
 
Session Code
 
   
FIGURE SKATERS ONLY
  Monday Tuesday Wednesday
Thursday Friday Saturday Sunday
   

RELEASE & INDEMNITY: We the undersigned parent(s) / guardian(s) of the above listed participants do hereby release SK8 Georgian Bay from all claims, actions, causes of actions, damages and demands for loss or injury resulting directly from the participation of our child in this program. This includes all costs, damages and expenses incurred in defending any such claims or actions against SK8 Georgian Bay. We understand that this is our commitment to honour this registration and that it is our responsibility to explain the commitment and school rules to our skater. We acknowledge that the student would not be accepted into this program but for our executing this release indemnity. The applicant and parent do not object to having names and/or pictures published or posted.

Applications are accepted on a first come, first served basis. Payment must accompany applications to reserve space. Requests for refunds must be made within 30 days prior to the start of the session. A $30.00 administration fee will be charged per request. All other refunds must be accompanied with a Doctor’s note

I Agree
 
     
Date
  - MM/DD/YY