2010 Fall School
Sept 10 - Oct 17, 2010
Int/Snr Friday 5:15-6:30
Sunday 11:15-12:30
Junior - Friday 5:45-6:30
Skater's Name_________________________________________
Sex: M____F____ Date of Birth (m/d/y) ______/_____ /______
Address__________________________________________________________________
City_________________________ Province____________ Postal Code_______________
Parents/Legal Guardian Name___________________________________
Phone Number_________________ E-Mail _______________________________
Medicare Number___________________ Medical Information ________________________
Skate Canada Number ____________________________ Date ____________________
Highest Stage Passed _________________Home/Previous Club_________________________
THE OROMOCTO SKATING CLUB WILL NOT BE RESPONSIBLE FOR ANY INJURIES SUSTAINED WHILE PARTICIPATING IN CLUB ACTIVITIES.
Signature______________________Print________________________Date___________
Applicant’s signature or parent/guardian’s signature if applicant is under 18 years of age
REGISTRATION FEE
Junior/Single day..……….…$80.00 Friday or Sunday Receipt Number ________________________
Intermediate/Senior…………$150.00 $ __________
Skate Canada Membership…...$31.00
Payment must be made in full on or before first day of skating. Please make cheques payable to the Oromocto Skating Club.
Skaters must be registered with Skate Canada for the 2010/2011 year.
All NSF cheques will be subject to a $25.00 charge.