CUTTING EDGE SUMMER SKATING SCHOOL
Box
1846 Virden, Manitoba R0M 2C0
Application
Form - Summer 2009
Name: _______________________________ Address:____________________________
City:___________________________ Province: _____ Postal Code: _________________
Phone: _____________________Email: ________________________________________
Date of Birth (d/m/y/) ____ / ____ / ____ Age: ______ Male: ________ Female: _________
Health Card # _____________________ Skate Canada # __________________________
Home Club _____________________ Home Club # _______________________________
MEMBERSHIP
REQUEST
□ INTERMEDIATE
□ PRE-COMPETITIVE SINGLES
□ COMPETITIVE
SINGLES □
ELITE COMPETITIVE SINGLES
SELECT DATES
□ July 13th
□ July
20th □
July
27th
□August 3rd □ August
10th □August 17th
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SELECT SESSIONS
□
7:30 □
8:30 □
9:15 □
10:10 □
11:20
□ 12:05 □
1:00 □
1:55 □
3:05 □
4:00
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Indicate Test Passed
Freeskate
Test: _______________________ Competitive Test:
___________________
Dance Test: __________________________ Skill
Test: __________________________
Competitive Dance Test: ________________ Competitive
Pair Test: ________________
Please indicate your coach/coaches at Cutting Edge Summer Skating School. Lessons are to be booked directly with coaches prior to Summer School.
Base Coach (1st Coach) ________________ 2nd Choice __________________
Number of Lessons Requested Per Week:
Free Skate __________ Skills ____________ Dance
________
SCHOOL ADMINISTRATION FEE:
Before April 25th -
$25.00
Before May 15th -
$40.00
After May 15th
- $50.00:
$___________________________
GST 5%: $_______________________________
TOTAL: $ _______________________________
ENCLOSED (50%): $______________________
BALANCE: $_____________________________
Liability
Agreement:
The
skater or if the skater is under 18, the skater and parents/guardians agree:
The skater skates at his/her own risk. The skater will not hold Cutting
Edge Skate School and it’s officers or employees or the Whitewood Community
Arena responsible for any loss or damage sustained through injury to the skater
or other skaters on or off the ice and/or other liability loss, damage or
expenses incurred as a result of the skater attending Cutting Edge Summer
Skating School 2009. The skater will abide by the rules of the club and
Skate Canada. All fees for skating booked will be paid in advance.
Coaching fees will be paid within 7 days of receipt of bill and paid in full
prior to taking tests.
SIGNED (parent/guardian) ______________________________
Date ______________________________
Placement of any skater on a session is the sole discretion of the director