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Name and Contact Information |
| Parent/Guardian Full Name:[*] |  | |
| Parent/Guardian E-Mail Address:[*] | | |
| Payer Name for Child Fitness Tax Receipt:[*] | | |
| Parent/Guardian Phone Number:[*] | | |
| Skater Membership Status |
Please indicate your skater's membership status. |
| Newmarket Skating Club Membership Status:[*] | | |
| Skater Information |
Please provide the following information about the skater |
| Skater's First Name:[*] | | |
| Skater's Middle Name: | | |
| Skater's Last Name:[*] | | |
| Age of Skater as of December 31, 2010:[*] | | |
| Street Address:[*] | | |
| City or Town:[*] | | |
| POSTAL CODE:[*] | | |
| Date of Birth:[*] | | |
| Gender:[*] | | |
Please enter any notes or comments in the space below |
| Notes: | |
|
If the skater has any allergies or medical conditions that we should be aware of, please enter them in the space below |
| Allergies or Medical Conditions: | |
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| Learning Disabilities or Special Issues: | |
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| Transfer Information |
Please provide the following information if your skater is transfering from another Skate Canada club |
| Skate Canada Membership Number: | | |
| Home Club Name and Number: | | |
| Payment Preference (NO REFUNDS after Dec 1/10) |
| Payment Choice:[*] | | |
| Private Coach(es) |
| List your private coach(es) if applicable: | |
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StarSkate Figure Skating Programs:
(Adv, Snr, Int begin Sept 7/10; Junior begins Sept 13/10) |
| SKILLS |
For Advanced, Senior, Intermediate.
All sessions in Forhan.
Please indicate choice: | | |
| SPINS & FIELD MOVES |
Maximum: 20 skaters per session (by priority)
All sessions available to all levels.
(1 ssn=$60, 2 ssns=$95, 3 ssns=$125)
These prices are the 10% discounted amounts.
Indicate your choice(s): | | |
OFF-ICE PROGRAM
(available to all Adv, Snr, Int, Jnr) |
Space is limited
No additional fee: | | |
| ADVANCED |
Full membership is 5 sessions/week.
Please indicate choices.
($1350.00 or six installments of $247.50): | | |
| SENIOR |
Full membership is 4 sessions/week.
Please indicate choices.
($1170.00 or six installments of $214.50): | | |
PARTIAL PROGRAM
Available to Advanced and Senior Only.
Indicate your choice from the list below: | | |
EXTRA SESSIONS:
# of Days - indicate choice of session above
($165.00 or six installments of $30.25): | | |
| INTERMEDIATE |
Program is 3 sessions/week.
Please indicate choices.
($990.00 or six installments of $181.50): | | |
| JUNIOR |
BEGINS Sept 13/10
Program is 2 sessions/week.
Please indicate choices.
NOTE: First day can be Mon, Tue or Thur.
Second day can be Thur or Sat.
($690.00 or six installments of $126.50): | | |
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