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Simply Print out the Form and send it to the address listed...or copy and paste it into a email...fill it out and email it to us.  Email address is listed above in the green box.

TOMAHAWK FIGURE SKATING CLUB, INC

2007-2008 REGISTRATION FORM

 

SKATERS NAME:         

Skating Level if Returning Skater: 

 

Date of Birth

Phone #

 

Parent/Guardian(s) Names

Address:

 

Phone Number #

Cell Phone #

 

Email Address:

 

 

If you are a returning skater did you meet your volunteer hours for the 2006-2007 Volunteer Season?  

Volunteer Hours will be verified with the club records!!!!!  Please be honest!

 

PLEASE COMPLETE ALL THREE OF THE FOLLOWING SECTIONS!

 

Section One:  Levels and Fees:  (All fees are due IN FULL by October 21, 2007)    No Child will be allowed on the ice without fees being paid in full.  This fee Does Not include costume fees for the ice show!  Please circle the Level you or your child is registering for:

 

Snow Plow Sam:  $150.00                   SP1         SP2         SP3                           

 Sunday Nights Only!

 

Basic Skills:  $225.00    

                        BS1           BS2            BS3             BS4  

                        BS5           BS6             BS7            BS8          

Wed and Sun. Nights

 

Freestyle:  $250.00      FS1         FS2         FS3         FS4     FS5    FS6        Wed and Sun. Nights

 

Adult Program:  $150.00          A- Snow Plow             A-Basic Levels          Sunday Nights Only! 

Adults with children in the program are not subject to additional volunteer hours.  Adults without children in the program will be asked to meet volunteer requirements and will be exempt from the fund raising requirement although we’d appreciate the participation!   

 

Competition Ice:  Additional Fee for those planning on Competing:   $150.00 for the season for additional scheduled times.                        Yes                                No

 

Section Two:   Fundraising-Raffle Tickets (All skaters must either participate in the raffle ticket fundraiser or pay a buy-out fee to the club.)

 

______ I agree to sell 30 raffle tickets and turn in all money no later than December 1, 2007.  I understand that any unsold tickets may not be

returned to the club!    Tickets are $5.00 each or 3 for $10.00

 

______I do not wish to sell the raffle tickets and will pay a one-time

buy out of $100,.00 to Tomahawk Figure Skating Club by

December 1, 2007.

 

Section Three:  Volunteer Hours   (A parent representative of each

skater is required to complete a minimum of 10 hours of volunteer

time or pay the buy-out fee to the club.)

 

____I agree to satisfy the 10 hour volunteer requirement.  I understand

that I am responsible for logging my time on the volunteer log hanging

on the bulletin board.  I understand that if I do not sign up, I will be

assigned an area to help out with.

 

____I do not wish to volunteer and agree to pay a $100.00 volunteer

buy-out fee by December 1, 2007. 

 

I, the undersigned, agree to uphold my Fundraising and Parent commitment in regards to the Tomahawk Figure Skating Club as

outline above.  Further, I agree to pay the buy-out fees listed above if my commitments are not upheld. 

 

Parent or Guardian Signature:   ______________________________Date____________________

 


EMERGENCY MEDICAL RELEASE

 

I, ___________________________  OF __________________________________, AM THE PARENT OR GUARDIAN OF

                (Parent/Guardian)                                                     (address)

________________________________, A MINOR, OF_________________________________________.

                (Skaters Name)                                                                        (address)

 I hereby give my consent, in the event that all reasonable attempts to contact me or my alternate emergency contact have been made, to

any and all medical/surgical care required in an emergency situation

that may arise during my child’s participation in the Tomahawk Figure Skating Club Programs.   I also consent to the transfer of my child to any hospital reasonably accessible.   The following information is needed

by any hospital or practitioner not having access to the child’s medical history.  This will not be used for any other purpose.  This release shall

be effective from October 1st, 2007 – April 30, 2007.  Furthermore I release

club from any and all liability associated with injury resulting from participation in the club and it's programs. 

 

Parent/Guardian Signature: __________________________________Date_____________________

 

Medical Insurance Company:                                                                       Policy #

Allergies:                                                                                                        Medications:

Last Tetanus:                                                                                                  Major Medical Problems

Other Pertinent Information Physician should know:

Alternate Contact:

Alternate Contact Phone and Cell Phone

Physician Name and Phone

Dentist Name and Phone

 

 

Summary of Fees Due for 2007-2008

Fees Due:  (Based on Level)                                              ________________

Competition Ice Purchase   ($150)                                    + ________________

Total Due before Contract Discount                                                =_________________

 

$100 Discount for Completing Parent Contract for 2006-2007 Season            - ______________

$20.00 Discount for Registering and submitting 1/2 of Fees by July 15th     -______________

Total                                                                                       =_________________

               

Amount Submitted with Registration Form Today:                      _________________

Balance of Registration Due by October 1st                                   _________________                                                            

 

Additional Fees Due by December 1st, 2007!!!!!

Volunteer Buy Out   ($100)  ________________

                Fund Raising Buy Out  ($100)   ________________

                Costume Fee of ( $50.00)       _________________

               

We will still be holding a registration this fall for anyone interested

in joining the club at that time!  

Any questions, please contact Shar Lombardo @ 715-551-9264 or

Linda Schlinsog @ 715-453-1907

Please make checks payable to:  Tomahawk Figure Skating Club

 

Amount Enclosed with Registration:   _________________  

Check #_______________

 

Please send this form along with your check to: 

Tomahawk Figure Skating Club  Attention: Registration

PO Box 223  

Tomahawk WI   54487

 

Please  Do Not Fill In this Section:  For Club Record Keeping Purposes Only 

_____Registration Form Received on :   ___________                                

_____Medical Waiver Received__________________

_____1st Half of Registration Fee Received  on  ___________   Amt______________Check #______________

_____2nd  Half of Registration Fee Received  on  ___________   Amt______________Check #_________________

_____Volunteer Buy Out Fee Received  on  ___________   Amt______________Check #_________________

_____Fund Raising Buy Out Fee Received on _______________

Amt _______________Check # ______________

_____Raffle Ticket Sales Monies Received on _____________

# Tickets Sold_______Amt Due_________Check #___________

_____Costume Fee of 50.00 Received on  _______________ Amt__________________Check #_______________

 

 

 

Have more questions or want more detailed information:

REGISTRATION NIGHTS! 

We will be at Sara Park on Sunday, September 30 from 5:30 to 7:00p.m for  registrations and also on Sunday, October 7th from 5:30 to 7:00 p.m.