Name _______________________________ Birthdate_____________ ISI #______ Expiration________
Street_______________________________ City________________ State_____ Zip Code___________
Phone _____________________ Emergency Phone _________________ Cell Phone ________________
Emergency Contact Person ________________________________ Phone ________________________
Mother's Full Name ___________________________ Father's Full Name ________________________
Current Skating Level __________________________ Skating Coach ____________________________
Where did you hear about us?___________________________EMAIL___________________________
Prices based upon 7 week session unless otherwise noted.
| NOTE: NO ICE
/ NO CLASSES May 16, 17, No practice ice May 26th |
SESSION 5 |
(7 weeks) |
| CLASSES |
FEE: |
AMOUNT: |
| Learn-to-Skate 10:45 -11:30 a.m. Saturday | $105.00 | |
| Learn-to-Skate 11:30- 12:15 a.m. Saturday | $105.00 | |
| Basic Skills: Alpha - Delta 12:25-1:55 p.m. Saturday | $154.00 | |
| Freestyle 1 - 4 7:20 -8:50 a.m. Saturday | $154.00 | |
| Freestyle 5 & 6 3:45-4:40 p.m. Friday | $126.00 | |
| Freestyle 7-10 4:50 - 5:40 p.m. Friday | $12600 | |
| Adult Class 7:40 - 8:40p.m. Tuesday (8 weeks) | $144.00 | |
| *PRACTICE ICE | ||
| Monday (2:15 - 3:00pm) | $ 56.00 | |
| Monday (3:00 - 4:25pm) | $ 84.00 | |
| Monday (6:35-7:35pm) | $ 77.00 | |
| Monday (7:45-8:45pm) | $ 77.00 | |
| Tuesday (2:15 - 3:00pm) (8 weeks) | $ 72.00 | |
| Tuesday (3:00 - 4:25pm) (8 weeks) | $ 96.00 | |
| Tuesday (8:50-9:50pm) ( 8 weeks) | $ 88.00 | |
| Wednesday (2:15 - 3:00pm) ( 8 weeks) | $ 72.00 | |
| Wednesday (3:00 - 4:25pm) ( 8 weeks) | $ 96.00 | |
| Thursday (6:30 - 7:30pm) ( 8 weeks) | $ 88.00 | |
| Friday (2:15 - 3:30pm) | $ 70.00 | |
| Saturday (9:00 - 10:00am) FS 1 & UP | $ 84.00 | |
| Saturday (9:15 - 9:45 a.m) Shooting Starlettes Synchro Team | $ 84.00 | |
| Saturday (9:45 - 10:45 a.m.) | $ 84.00 | |
| Saturday (1:30 - 2:15 p.m.) Shooting Stars Synchro Team | $ 98.00 | |
| Saturday (2:05 - 3:05 p.m.) | $ 84.00 | |
| *LATE FEE | $10.00 | |
| TOTAL: |
-Make checks payable to Nashoba Valley ISI (NVO ISI). $15 fee
for returned checks. NVO ISI does not accept credit cards.
-NVO ISI reserves the right to cancel any class/practice ice in the even of
insufficient enrollment.
-No refunds except for medical reasons documented by a doctor's note. No exceptions.
-Class family discount (parents/siblings): 1st family member pays 100%, 2nd
family member- 5% discount, 3rd family member- 10% discount.
-Private lessons available at rate of $ 24.00 per ½ hour- effective September
2006.
* LATE FEE $10.00 charged for late re-registrations (if not paid by
first class of session).
RELEASE FORM: I hereby absolve NVO ISI staff and all related
agents of all responsibilities for injury or illness to the above skater and
hold the above parties and their agents harmless from all claims. All skaters
participate at their own risk.
_____________________________________________
Signature (parent if skater is under 18 years)
PHOTO RELEASE: I hereby agree that any photographs
or video tapes of the above skater, taken by NVO ISI or any authorized party,
may be used exclusively for any purpose by NVO ISI or any other use authorized
by NVO ISI.
____________________________________________________________
Signature (parent if skater is under 18 years)