St. Moritz Ice Skating Club
2013-2014 Membership Information
New Memberships or Renewals may be done online
Follow the link on the club website
There are 3 options for you to renew your membership with us.
- Use the link provided to renew online and pay by credit card (Visa, Mastercard or Discover only). There is a 3.3% processing fee charged by the website.
- Use the link provided to renew online and update your information; however, do not check out and instead write a check or money order payable to St. Moritz ISC and send to Jean Fahmie, 1161 Chopin Ter #200, Fremont, CA 94538.
- Download the membership forms from our website and mail to Jean Fahmie, Membership Chair (address in #2 above) with a check or money order.
In order to complete your membership registration with U.S. Figure Skating, all members must sign and return the liability & waiver form. You will not be a member in good standing until this form is returned.
Liability forms may be returned:
1.By mail to Jean Fahmie, 1161 Chopin Terrace #200, Fremont, CA 94538.
2.At Dublin Iceland: in the labeled envelope posted on the bulletin board next to the Skating School Director’s office
3.At Oakland Iceland: in the plastic slot labeled for St. Moritz across from the skate counter near the entrance to the manager’s offices.
4.Scan the forms and send to
St. Moritz Ice Skating Club
2013-2014Membership Categories
Primary Memberships– Includes US Figure Skating Membership
and Skating Magazine
Adult or Junior Membership: $110
Full membership allows testing, competing or joining Club Sessions. Adult members are eligible for election to the Board of Directors.
Introductory Membership: $40
Full membership for those who have never been US Figure Skating members
Collegiate Membership: $100
One time 4 year full membership for undergraduate or graduate college students – this membership cannot be renewed.
Coach Membership: $50
Full membership for coaches – Registration with US Figure Skating
and PSA membership recommended. Must have liability insurance.
Home Club Associate Membership: $50
Voting membership for Officials, Club Alumni or non-skaters
at least 18 years old. No testing or competing.
Not eligible for Board membership
Subsequent Memberships– Includes US Figure Skating Membership
Second or Subsequent Membership: $75
Full membership for skater at same address as first family member.
Allows testing, competing, joining club sessions
Second/Subsequent Coach Membership: $40
Second Coach at same address as primary member
Parent / Non-Skating Membership: $10
Voting Membership for Parents/Guardians of Primary members under 18. Must live at the same address asthe primary member.
Non-Home Club Associate Membership: $40
For skaters who are primary members of another club andskate on Club Sessions or synchro teams. US Figure Skating Membership not included.
St. Moritz Ice Skating Club
2013-2014Information Sheet
Please complete all inforMATION and sign Waiver and Liability form
Member ID: ______ Mr. Ms Miss Mrs.
(New members will be assigned a USFigure Skating membership number upon registration)
Membership Category ______
Name:
Address:
City/State/Zip:
Home Phone: _Cell: Work:
Email:
Please add my name to the club email list: Yes / No / On List
Date of Birth _____/_____/_____ U.S. Citizen?Yes No Gender M F
Rink: Dublin Oakland Out of Area Not Skating
If skater is under 18: Parents Name______
If adding Parent Membership – Parent Date of Birth _____/_____/_____
1. PRIMARY ACTIVITY (Choose one): Competitive Skater Parent/Guardian
U.S. Figure Skating Official / Officer Club Officer / Board Member Coach
Recreational Skater (includes taking tests) Other
2. CHECK ANY OTHERS THAT APPLY: Adult Skater Synchro Collegiate Coach
Competitive Skater Parent/Guardian Ice Dancer Recreational Skater (includes testing)
U.S. Figure Skating Official/Officer Club Officer/Board Member Club Volunteer
Attach Check or Money Order payable to St. Moritz ISC.
Mail check, St. Moritz information sheet and waiver and release of liability to
St. Moritz ISC, c/o Jean Fahmie, 1161 Chopin Terrace #200, FremontCA94538
St. Moritz Ice Skating Club
Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (“Agreement”) 2013-2014
In consideration of participating in St. Moritz Ice 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 St. Moritz Ice 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 St. Moritz Ice 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 St Moritz Ice Skating Club shall not be responsible for the supervision of the members at Club Ice.
I hereby grant permission for myself or child/ward to participate in the activities of the St. Moritz Ice Skating Club (SMISC). I understand that my or my child/ward’s name and photograph may be used in SMISC publications, advertisements and promotions in print or on the SMISC website. I further understand that it is my responsibility to notify the SMISC in writing if I want to revoke or restrict permission to use my or my child/ward’s name or photograph in this manner.
I hereby agree that I or my child/ward will abide by the Bylaws of the St. Moritz Ice Skating Club and will adhere to the Code of Conduct, rules, and policies of the St. Moritz Ice Skating Club and its sessions as well as U.S. Figure Skating, and will observe ice etiquette and courtesy at all times. Total Dues/Assessments are due and payable upon signing and submitting the Application/Registration form. I understand that failure to abide by these rules may result in suspension or loss of membership privileges.
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.
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Printed Name of ParticipantDate
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Signature of Participant - if under 18, please complete Parental Consent and Indemnification agreement
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.
______
Print Name of Parent/Guardian Date
______
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 St.
Moritz Ice Skating Club and the facility the activities are taking place in and their staff and to members of the St Moritz Ice Skating Club , 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.
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Print name of minor child member or Adult Member
______
Print name of Parent or Guardian for members under 18
______
Signature of Adult MemberDate
______
Signature of Parent or Guardian for members under 18Date
This Consent for Medical Attention shall be binding and effective for the 2013-2014membership year of the St. Moritz Ice Skating Club. July 1, 2013 – June 30, 2014
.