CANSKATE Fall Registration Form

CanSkate Registration

November 5th - December 17th

Skater Name

Date of Birth

Address (including City & Postal Code)

Parent/Guardian Name & Phone Number (Home/Cell)

Emergency Contact Name & Phone Number

Parent/Guardian Email Address

CanSkate

November 5th - December 17th (7 weeks)

Thursdays 6:05 - 6:45pm $150.00

This fee includes the annual Skate Canada registration fee of $44.00.

Payment - please send e-transfer to info@quintefsc.com

*If registration numbers are lower than anticipated, QFSC reserves the right to cancel the session.

1) The undersigned skater/parent/guardian hereby agree(s) to hold and save harmless the Quinte Figure Skating Club, all officers, directors, executive members, committee members and coaches from any claims for injuries, damage or loss of any kind whatsoever, however or whoever caused, and aforesaid jointly and severally are released by the undersigned from any and all such claims. The undersigned also agrees to abide by all Skate Canada and QFSC rules in effect, or as amended from time to time.

2) The Quinte Figure Skating Club may, from time to time, take photos or video of your child for the purpose of promoting the Club. Approval is given for these photos to be posted on the Club’s bulletin boards, website, social media or printed in news media.

Select an option

Yes

By inserting my name in the space below, I (the parent/guardian) am signing this document: