Skater Entry Form

Freestyle Entry Form

2012 Prince Edward Island STARSkate Championships

O’Leary Community Sports Centre

March 2-4, 2012

Please print clearlyDeadline: January 9, 2012

Competitor’s Name______Skate Canada #______

Birthdate: Day______Month______Year______Age:______

Female______Male______First STARSkate Competition: ______Yes _____ No

Mailing Address______

______Email address______

Parent/Guardians Name:______Phone #______

Coaches Name:______Phone #______

Name of Event being entered:______

Highest Freeskate Test Passed______

Once submitted any changes to your form will automatically cost the competitor $5.00 per change

Please make cheque or money order payable to your home club.

Home Club Test Certification and Approval

Name of Club______Club #______

Test Chairpersons Signature:______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Please Note: It is the competitor’s responsibility to rewind their tapes before they are left at registration, if you do not rewind your tape, it will be returned to you.

Clubs are responsible for collecting all entry forms from skaters and sending the skater entry forms, event fees (one cheque per club for all entries made out to Skate Canada P.E.I.) and a type written list of entries (form attached) by January 9th, 2012 to:

Michelle Neill Event Fees: Freestyle $20.00/entry

1427 Rustico Road- route 7

Oyster Bed, C1E 0X8

902.218.1590

Check our website for schedule at

Dance Entry Form

2012 Prince Edward IslandSTARSkate Championships

O’Leary Community Sports Centre

March 2-4, 2012

Please submit 1 entry for each Dance Team:(print clearly)Deadline: January 9, 2012

Name of Dance Event entered:______

Competitor’s Name______Skate Canada #______

Birthdate: Day______Month______Year______Age:______

Mailing Address______

______Email address ______

Female______Male______First STARSkate Competition: ______Yes _____ No

Parent/Guardians Name:______Phone #______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Coaches Name:______Phone #______

Highest Dance Test Passed______

PARTNER:

Competitor’s Name______Skate Canada #______

Birthdate: Day______Month______Year______Age:______

Mailing Address______

______Email address:______

Female______Male______First STARSkate Competition: ______Yes _____ No

Parent/Guardians Name:______Phone #______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Coaches Name:______Phone #______

Highest Dance Test Passed______

Once submitted any changes to your form will automatically cost the competitor $5.00 per change

Please make cheque or money order payable to your home club.

Home Club Test Certification and Approval

Name of Club______Club #______

Test Chairpersons Signature:______

Clubs are responsible for collecting all entry forms from skaters and sending the skater entry forms, event fees (one cheque per club for all entries made out to Skate Canada P.E.I.) and a type written list of entries (form attached) by January 9th, 2012to:

Michelle NeillEvent Fees: Dance $30.00/team

1427 Rustico Road- route 7

Oyster Bed, C1E 0X8

902.218.1590

Check our website for schedule at

Interpretive Entry Form

2012 Prince Edward Island STARSkate Championships

O’Leary Community Sports Centre

March 2-4, 2012

Please print clearlyDeadline: January 9, 2012

Competitor’s Name______Skate Canada #______

Birthdate: Day______Month______Year______Age:______

Female______Male______First STARSkate Competition: ______Yes _____ No

Mailing Address______

______Email address:______

Parent/Guardians Name:______Phone #______

Coaches Name:______Phone #______

Name of Event being entered:______

Name of Interpretive Program:______

Highest Interpretive Test Passed______

Once submitted any changes to your form will automatically cost the competitor $5.00 per change

Please make cheque or money order payable to your home club.

Home Club Test Certification and Approval

Name of Club______Club #______

Test Chairpersons Signature:______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Please Note: It is the competitor’s responsibility to rewind their tapes before they are left at registration, if you do not rewind your tape, it will be returned to you.

Clubs are responsible for collecting all entry forms from skaters and sending the skater entry forms, event fees (one cheque per club for all entries made out to Skate Canada P.E.I.) and a type written list of entries (form attached) by January 9th, 2012 to:

Event Fees: Interpretative $20.00/entry

Michelle Neill

1427 Rustico Road- route 7

Oyster Bed, C1E 0X8

902.218.1590

Check our website for schedule at

Pairs Entry Form

2012 Prince Edward Island STARSkate Championships

O’Leary Community Sports Centre

March 2-4, 2012

Please submit 1 entry for each Pairs Team:(print clearly)Deadline: January 9, 2012

Name of Pairs Event entered:______

Competitor’s Name______Skate Canada #______

Birthdate: Day______Month______Year______Age:______

Mailing Address______

______Email address ______

Female______Male______First STARSkate Competition: ______Yes _____ No

Parent/Guardians Name:______Phone #______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Coaches Name:______Phone #______

Highest Pairs Test Passed______

PARTNER:

Competitor’s Name______Skate Canada #______

Birthdate: Day______Month______Year______Age:______

Mailing Address______

______Email address:______

Female______Male______First STARSkate Competition: ______Yes _____ No

Parent/Guardians Name:______Phone #______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Coaches Name:______Phone #______

Highest Pairs Test Passed______

Once submitted any changes to your form will automatically cost the competitor $5.00 per change

Please make cheque or money order payable to your home club.

Home Club Test Certification and Approval

Name of Club______Club #______

Test Chairpersons Signature:______

Clubs are responsible for collecting all entry forms from skaters and sending the skater entry forms, event fees (one cheque per club for all entries made out to Skate Canada P.E.I.) and a type written list of entries (form attached) by January 9th, 2012to: Event Fees: Pairs $30.00/team

Michelle Neill902.218.1590,

1427 Rustico Road- route 7

Oyster Bed, C1E 0X, Check our website for schedule at

Team Event Entry Form (Page 1)

2012 Prince Edward Island STARSkate Championships

O’Leary Community Sports Centre

March 2-4, 2012

Please submit 1 entry for each Team (2 pages):(print clearly)Deadline: January 9, 2012

Name of Team Event entered:______

Competitor #1

Competitor’s Name______Skate Canada #______

Mailing Address______

______Email address ______

Female______Male______First STARSkate Competition: ______Yes _____ No

Parent/Guardians Name:______Phone #______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Coaches Name:______Phone #______

Highest complete Freeskate Test Passed______

Competitor #2:

Competitor’s Name______Skate Canada #______

Mailing Address______

______Email address:______

Female______Male______First STARSkate Competition: ______Yes _____ No

Parent/Guardians Name:______Phone #______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Coaches Name:______Phone #______

Highest Pairs Test Passed______

Once submitted any changes to your form will automatically cost the competitor $5.00 per change

Please make cheque or money order payable to your home club.

Home Club Test Certification and Approval

Name of Club______Club #______

Test Chairpersons Signature:______

Clubs are responsible for collecting all entry forms from skaters and sending the skater entry forms, event fees (one cheque per club for all entries made out to Skate Canada P.E.I.) and a type written list of entries (form attached) by January 9th, 2012to:

Event Fees: Team Event: $20.00/team

Michelle Neill902.218.1590,

1427 Rustico Road- route 7

Oyster Bed, C1E 0X, Check our website for schedule at

Team Event Entry Form (Page 2)

2012 Prince Edward Island STARSkate Championships

O’Leary Community Sports Centre

March 2-4, 2012

Please submit 1 entry for each Team (2 pages):(print clearly)Deadline: January 9, 2012

Name of Team Event entered:______

Competitor #3

Competitor’s Name______Skate Canada #______

Mailing Address______

______Email address ______

Female______Male______First STARSkate Competition: ______Yes _____ No

Parent/Guardians Name:______Phone #______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Coaches Name:______Phone #______

Highest complete Freeskate Test Passed______

Competitor #4:

Competitor’s Name______Skate Canada #______

Mailing Address______

______Email address:______

Female______Male______First STARSkate Competition: ______Yes _____ No

Parent/Guardians Name:______Phone #______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Coaches Name:______Phone #______

Highest Pairs Test Passed______

Once submitted any changes to your form will automatically cost the competitor $5.00 per change

Please make cheque or money order payable to your home club.

Home Club Test Certification and Approval

Name of Club______Club #______

Test Chairpersons Signature:______

Clubs are responsible for collecting all entry forms from skaters and sending the skater entry forms, event fees (one cheque per club for all entries made out to Skate Canada P.E.I.) and a type written list of entries (form attached) by January 9th, 2012to: Event Fees: Team Event: $20.00/team

Michelle Neill902.218.1590,

1427 Rustico Road- route 7

Oyster Bed, C1E 0X, Check our website for schedule at

Creative Dance Entry Form

2012 Prince Edward Island STARSkate Championships

O’Leary Community Sports Centre

March 2-4, 2012

Please print clearlyDeadline: January 9, 2012

Competitor’s Name______Skate Canada #______

Birthdate: Day______Month______Year______Age:______

Female______Male______First STARSkate Competition: ______Yes _____ No

Mailing Address______

______Email address:______

Parent/Guardians Name:______Phone #______

Coaches Name:______Phone #______

Name of Event being entered:______

Highest Complete Dance Test passed______

Once submitted any changes to your form will automatically cost the competitor $5.00 per change

Please make cheque or money order payable to your home club.

Home Club Test Certification and Approval

Name of Club______Club #______

Test Chairpersons Signature:______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Please Note: It is the competitor’s responsibility to rewind their tapes before they are left at registration, if you do not rewind your tape, it will be returned to you.

Clubs are responsible for collecting all entry forms from skaters and sending the skater entry forms, event fees (one cheque per club for all entries made out to Skate Canada P.E.I.) and a type written list of entries (form attached) by January 9th, 2012 to:

Event Fees:Creative Dance $20.00/entry

Michelle Neill

1427 Rustico Road- route 7

Oyster Bed, C1E 0X, 902.218.1590,

Check our website for schedule at

Gold Creative Skill Entry Form

2012 Prince Edward Island STARSkate Championships

O’Leary Community Sports Centre

March 2-4, 2012

Please print clearlyDeadline: January 9, 2012

Competitor’s Name______Skate Canada #______

Birthdate: Day______Month______Year______Age:______

Female______Male______First STARSkate Competition: ______Yes _____ No

Mailing Address______

______Email address:______

Parent/Guardians Name:______Phone #______

Coaches Name:______Phone #______

Highest Skating Skill Test Passed______

Once submitted any changes to your form will automatically cost the competitor $5.00 per change

Please make cheque or money order payable to your home club.

Home Club Test Certification and Approval

Name of Club______Club #______

Test Chairpersons Signature:______

PARENT OR GUARDIANS SIGNATURE (if a minor) ______

Please Note: It is the competitor’s responsibility to rewind their tapes before they are left at registration, if you do not rewind your tape, it will be returned to you.

Clubs are responsible for collecting all entry forms from skaters and sending the skater entry forms, event fees (one cheque per club for all entries made out to Skate Canada P.E.I.) and a type written list of entries (form attached) by January 9th, 2012 to:

Event Fees:Gold Creative Skill $20.00/entry

Michelle Neill

1427 Rustico Road- route 7

Oyster Bed, C1E 0X,

902.218.1590,

Check our website for schedule at