Brooklyn Park Figure Skating Club

Three Rivers Figure Skating Club

2017-2018 Membership Application (7/1/17 – 6/30/18)

Member's Name ______US Figure Skating # ______

Email Address (Preferred) ______Second Email ______

Address ______Date of Birth ______

City ______State ______Zip ______

Parent(s) ______Phone (H) ______

Cell Phone Mother ______Father ______

Private Coach’s Name ______Member’s Cell ______

Three Rivers Figure Skating Club Membership Types

Senior Club Member – Skater has passed USFS* Basic Skills Freeskate 3 Group Lessons & Higher

Junior Club Member – Skater has passed USFS* Basic Skills Basic 6 – Freeskate 2 Group Lessons

Collegiate Member – Senior Club Four Year Membership (7/1/17 – 6/30/21) Contact Mike for Details

Associate Member – Skater belongs to another Home Club OR Is an Individual USFS Member

Coaches, Associate Coaches & Non Skating Senior Club Member

Marshall – Skater skates in Marshall, MN (Senior Club)

*USFS – US Figure Skating (All TRFSC Memberships Include a 1 Year Membership to USFS)

I have read the Skaters, Parents and Professional Staff Expectations on the back of this form.

______

Member’s signatureParents signature

(Required for members under 18)

Make Check Payable to “Three Rivers Figure Skating Club” or “TRFSC”

Questions???? Please contact Mike Itzin 612-251-4557 or

Mail Membership Forms & Payment To: Mike Itzin, 7949 Idaho Ave N, Brooklyn Park MN 55445-2614

EXPECTATIONS

Expectation of Skaters

1. I will work toward and support:

a) Individual growth and excellence in figure skating.

b) Positive and constructive behavior with all of my fellow skaters, other parents and professional staff in the Club.

c) Respect and appreciation for the individual and different personalities and skills of all skaters and Pros.

d) Feeling of “belonging” to the Club, Club unity and working together to accomplish Club goals.

e) Support and respect for all skaters participating in competitive events.

2. I will be respectful of all skaters, Pros and others at the ice arena by exhibiting appropriate behavior at all times.

3. I will read and follow the Ice Rules that are written in the TRFSC Handbook.

4. I will abide by the disciplinary procedures as outlined in the Expectations of Professional Staff and restated below:

a) All Pros are responsible to be observant for inappropriate skating etiquette.

b) If inappropriate skating etiquette is observed, the Pro of the skater involved and the Pro who observed the behavior will meet

off the ice and all parties will address and resolve the problem. This will take place at the time of the incident.

c) If the skater’s Pro is not present, the issue will be discussed with the skater, and the skater’s Pro will be notified as soon as

possible.

5. If I disagree with how I was treated, I will follow the Grievance Procedure, as outlined by the Board.

6. I will conduct myself chemically free (alcohol, illicit drugs) whenever participating in a Club skating session or skating

competition.

Expectation of Parents

1. I will review and explain the Expectations of Skaters with my skater(s). I will support and respect these Expectations.

2. I will review and explain the Expectations of Professional Staff with my skater(s). I will support and respect all Pro’s

Philosophies, work and disciplinary procedures.

3. I will be respectful of skaters, Pros, and others at the ice arena by exhibiting appropriate behavior at all times.

4. I will support the Club by:

a) Volunteering to help with the Annual Show, if possible.

b) Participating in fundraising activities.

c) Participating in other Club activities as requested.

d) Paying my bills on time.

5. I will use the Grievance Procedure whenever I, or my skater(s) has/have a problem which cannot be informally resolved.

6. I will conduct myself chemically free (alcohol, illicit drugs) whenever attending a Club skating session or skating competition.

Expectation of Professional Staff

1.I will be a role model and facilitate:

a) Individual growth and excellence in skating for all members of the Club.

b) Positive and constructive interaction between all skaters, parents, and Pros in the Club

c) Respect and appreciation for the individual and unique personalities/skills of all skaters and Pros in the Club.

d) Feeling of “belonging” to the Club, club unity, and working together to accomplish Club goals.

e) Support and respect for all skaters participating in competitive events.

2.I will support and respect other Pros and their philosophy, work and disciplinary procedures, and treat all skaters fairly.

3.I will cooperate with other Pros and skaters regarding space on the ice by moving around and using the whole rink, and holding

meetings with groups of my skaters off the ice.

4. I have the authority to maintain a positive training atmosphere on the ice.

5. I will provide all of my students with written documentation of my fees and expectations, upon contracting services with them.

6. I will talk to each of my students about proper skating procedures and behavior on the ice, following all of the Ice Rules as

presented in the TRFSC Handbook and demand proper behavior at all times.

7. All Pros are responsible to be observant for inappropriate skating etiquette. If inappropriate skating etiquette is observed, the Pro

of the skater involved and the Pro who observed the behavior will meet off the ice and all parties will address and resolve the

problem. When possible, this should take place at the time of the incident. If the skater’s Pro is not present, the issue will be discussed with the skater, and the skater’s Pro will be notified as soon as possible.

8. If I need help with a problem, I will follow the appropriate Grievance Procedure, as outlined by the Board.

9. I will conduct myself chemically free (alcohol, illicit drugs) whenever participating in a Club skating session or skating

competition.

10. I will support the TRFSC Board and the Club as I do my work.

11. Pros on staff should not request skaters to become home club skaters elsewhere. Pros who repeatedly do this are subject to losing

their teaching status at the TRFSC.

12. I will conduct myself according to the Pro’s Ethics as presented in the TRFSC Handbook.

Three Rivers Figure Skating Club

Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (“Agreement”)

In consideration of participating in Three Rivers Figure Skating Club activities, I represent that I understand the nature of figure skating activities (“activity”) and that I am qualified, in good health and in proper physical condition to participate in such “activity”. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue participation in the “activity”.

I fully understand that this “activity” involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the “activity”, the conditions in which the “activity” takes place, or the negligence of the “releasees” named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation in the “activity”.

I hereby release, discharge, and covenant not to sue the Three Rivers Figure Skating Club , United States Figure Skating, it’s directors, officers, administrators, sponsors, volunteers, agents, employees, staff, instructors, trainers, other participants and if applicable, owners and lessors of premises on which the “activity” takes place (each considered one of the “Releasees” herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations; and I further agree that if, despite this release, waiver of liability, and assumption of risk, I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the releasees from any loss, liability, damage, or cost which any may incur as the result of such claim.

The Three Rivers Figure Skating Club has the right, but not the obligation, to provide rules, regulations and/or ice monitors for Club Ice. We hereby acknowledge that the Three Rivers Figure Skating Club shall not be responsible for the supervision of the members at Club Ice.

I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.

______

Printed Name of Participant Date

Signature of Participant / Parent/Guardian

SafeSport Statement for Membership Renewal

TRFSC is committed to creating a safe and positive environment for members’ physical, emotional and social development and ensuring that it promotes an environment free of misconduct.

The following code of conduct applies to all participants in activities hosted, supported, sponsored or engaged in by U.S. Figure Skating and (Club/Program/Rink) including but not limited to competitions, exhibitions, training camps and local rink activities.

I recognize that my participation or my child's in all the activities associated with U.S. Figure Skating and (Club/Program/Rink) is an honor and privilege that carries certain responsibilities. I agree to fully abide by the rules and guidelines set forth by U.S. Figure Skating or its properly designated agents.

U.S. Figure Skating Member Code of Conduct GR 1.02

I recognize that my participation in all activities hosted, supported, sponsored or engaged in by U.S. Figure Skating, including but not limited to competitions, exhibitions and training camps, is an honor and privilege that carries certain responsibilities. I agree to fully abide by the rules and guidelines set forth by U.S. Figure Skating or its properly designated agents. As a precondition to participation in activities hosted, supported, sponsored or engaged in by U.S. Figure Skating, I will adhere to the following tenets in good faith:

A. I will exhibit the highest standards of fairness, ethical behavior and genuine good sportsmanship in all of my relations with others.

B. I will not damage public or private property. I understand that I may be held financially responsible for damage deemed to be wantonly or willfully executed on my part, and that I may be subject to disciplinary action by U.S. Figure Skating.

C. I will not use or possess illegal drugs, and I will not engage in criminal activity. I understand that, if I am found to use or possess illegal drugs, or if I am found to engage in any criminal activity during any activity hosted, supported, sponsored or engaged in by U.S. Figure Skating, I may be subject to criminal penalties as well as penalties imposed by U.S. Figure Skating.

D. I will adhere to the rules of U.S. Figure Skating and the host organization at all activities hosted, supported, sponsored or engaged in by U.S. Figure Skating.

E. I will comply with all applicable anti-doping rules including, but not limited to, ISU and USADA anti-doping rules.

F. I will conduct myself in a manner not detrimental to the welfare of figure skating. I understand that my actions reflect on U.S. Figure Skating and the sport of figure skating both positively and negatively. I understand that if my acts, statements, or conduct are considered detrimental to the welfare of figure skating by the appropriate authority, I may be subject to penalties imposed by U.S. Figure Skating pursuant to GR 1.04.

G. I understand that the penalties that may be imposed may include, but are not limited to, loss of future international selections, loss of financial support from U.S. Figure Skating and its Memorial Fund, and loss of participation in activities hosted, supported, sponsored or engaged in by U.S. Figure Skating.

H. I understand that all disciplinary proceedings will be conducted pursuant to Article XXV, Section 3, of the U.S. Figure Skating bylaws, and that my rights and remedies are derived therefrom.

PARENTAL CONSENT AND INDEMNIFICATION AGREEMENT

I, the minor’s parent and/or legal guardian, understand the nature of the above referenced activities and the minor’s experience and capabilities and believe the minor to be qualified to participate in such “activity”. I hereby release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees from all liability, claims, demands, losses, or damages on the minor’s account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, the minor, or anyone on the minor’s behalf makes a claims against any of the above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any Releasees may incur as the result of any such claim.

______Date______Printed Name of Parent/Guardian

Signature of Parent/Guardian

Consent for Medical Attention or Treatment

I certify that I, the member, or I, the parent/guardian of said participant, give my consent to the

and the facility the activities are taking place in and their staff and to members of the , their Board of Directors and volunteers to obtain medical care from any licensed physician, hospital or clinic, including transportation and emergency medical services, for myself/ourselves and/or said participant for any injury that could arise from participation in these activities.

______

Name of 1st Minor Child Member (please print) Name of 2nd Minor Child Member (please print)

Name(s) of Parent(s)/Guardian(s)

(please print)

1st Parent/Guardian Signature Date

2nd Parent/Guardian Signature Date

Name of 1st Adult Member

(please print)

1st Adult Member Signature Date

Name of 2nd Adult Member

(please print)

2nd Adult Member Signature Date

This Consent for Medical Attention shall be binding and effective for the 2016-2017 membership year of the

Three Rivers Figure Skating Club

Three Rivers Figure Skating Club

2016-2017 Volunteer Survey

The TRFSC has many activities and areas that are in need of volunteer assistance. Below is a list of opportunities which may interest you; please circle all items that pique your interest. If you are interested in chairing a particular area, please indicate that next to the item. Your preferences will be shared with the appropriate committee chairs throughout the year. In addition we ask you use online sign ups when they are offered. Thank you for your time and support!

• Assisting at Skating Schools
• Food Perspectives
• Ice Monitoring
• Maple Grove Ice Show

• Club Apparel
• Judges Hospitality
• Public Relations
• Skate in the Park Co-Chairs
• Testing
• Website

__ I choose not to volunteer; I understand that I will be billed $120.00

Please print clearly

Skater's Name:______Phone:______

Parent's Name:______Parent's Email:______

Skill/Occupation:______

**Please fill out this survey and return it along with your completed membership forms**

Three Rivers Figure Skating Club

2017-2018 Volunteer Time Guidelines

The Three Rivers FSC relies on all parents to volunteer their time for the club’s activities and general operation. The Board of Directors has found it necessary to require each family to commit to 10 volunteer hours per membership year. If you choose to volunteer greater than 10 hours, your generosity is greatly appreciated. We would like to thank you in advance for your time and commitment. Below are the Volunteer Guidelines and attached is a volunteer interest survey to fill out and return with your completed membership forms.

Guidelines:

• Senior Club Families need to complete 10 volunteer hours per membership year
  (July 1, 2017 – June 30, 2018).
  
• For those who choose not to volunteer, a fee of $120 will be billed on
  July 1, 2018.
  
• The $120.00 fee will also be charged if fewer than the required 10 volunteer hours are completed and documented by July 1, 2018.
  
• At every volunteer event, you must provide your name and number of hours volunteered to the chairperson or coordinator of the event. The chair/coordinator will, in turn, email the hours to the Volunteer Chairperson who will log them accordingly.
  
• No experience is necessary; on-the-job training will be provided.

If you choose to volunteer the 10 required hours, you will be contacted periodically to fulfill volunteer needs throughout the club. When filling out the survey on the back of this form, please be sure to include a current e-mail address and phone number for ease of contact.

Questions? Please contact:

Mike Itzin

Phone: 612-251-4557

Email:

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