Power Skating Skills School Registration Form

Please note: Some classes will fill up early. All applications are handled on a first come, first served basis. Please complete and submit this registration form to me as soon as possible. 
I will phone or e-mail you, to arrange payment. If I receive your check within two weeks of that date your entry date will be the date that I received your completed registration form. 
Thanks... Moni Johnson

Skater Name:

Age:

Parents Name:

Phone No.

Street Address:

Apt. #

City: 

Postal Code:

Health Card Number:

e-mail address:

Requests to Skate From: (check 1 hour only)

 First Hour  1:00 PM 5 to 8 years old

Second Hour  2:00 PM 9 to Adult

On the following Session (check one)
 8 Week Winter Session 1 ($270.00) - 2011 see classes for dates
8 Week Winter Session 2 ($270.00) - 2012 see classes for dates
16 Week Winter Sessions 1 & 2 ($530.00) see classes for dates
 
By submitting this form, I certify that I have read and agree to all information listed in the TERMS section of this website and I give my approval to my child's full participation at the Power Skating Skills School. I further agree to hold harmless the Power Skating Skills School, it's staff or the Arena, from any and all claims for injury or loss, however caused.

      

For PDF form see contact page


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