Learn to Skate Registration Successful

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Please print this page for your records.  Also, we have sent a copy to email to .  Please email questions to SkateCompanySkatingClub.gmail.com.

Thanks,
Skate Company Skating Club


SKATE COMPANY SKATING CLUB

BASIC SKILLS/ LEARN TO SKATE

ALL SNOWPLOW SKATERS SHOULD WEAR A HELMET.

MAKE CHECKS PAYABLE TO: SKATE COMPANY SKATING CLUB

Skater’s Name:

Address:

City:

Zip:

Phone:

Age: DOB: (DD/MM/YYYY)
Grade:

Sex:

Last Class Passed:

SCSC Member:

Session:

E-Mail:

Class: Day:
Time:
Class Fee:

Late Fee:

Interest in Ice Show:
Registration Fee:

Total:

Waiver: In consideration of your accepting this entry form, I hereby for my child/ward, my heirs, executors and administrators, waiver and release any and all rights and claims for damages I or my child may have against the Skate Company Skating Club, or its representatives, for any or all injuries suffered while participating in this activity. I further represent that I am in good physical condition and have no disability or ailment that will prevent me from engaging in the activity for which I am registered. In addition, I hereby authorize Skate Company Skating Club to use all photos, both video and audio portions of videotapes on which my dependent or I appear.
Signature: s\
Form of Payment
Cash $ _____ FM $________
Check $_____ Check# ________
Date: Received By:

Emergency Contact Information

First Contact

Second Contact

Name:

Name:

Relation:

Relation:

Phone (Home):

Phone (Home):

Phone (Cell):

Phone (Cell):

Email:

Email:

Payment Methods

Skate Company Skating Club offers many ways to pay your Learn to Skate fees. We try to provide as many options as we can, so you can focus on what works best for you.
Credit card: We accept American Express, Discover, Visa, and MasterCard via PayPal. Please click the “Credit Card” icons below the “Pay Now” icon above.

PayPal: We accept money sent via PayPal. Please click the “Pay Now” icon above.

Check or money order: Make checks or money orders payable to “Skate Company Skating Club” and mail to: P.O Box 977, Lincoln Park, Mi 48416 within 7 days of this invoice. Also, you may arrangements with Deb Van Cleave to drop your check with her.

Please, do not mail cash. We will not accept via mail.

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