Level I & Ii Winter Ice Registration

IVERSON SKATING ACADEMY 2017 – 2018 CHISHOLM SPORTS ARENA LEVEL I & II WINTER ICE REGISTRATION

Skaters Name: ______

Date of Birth: ______USFSA Number: ______Basic Skill Level: ______

Address: ______City: ______Zip: ______

Cell Phone: ______Home Phone: ______Other: ______

Cost & Options: $500.00 Option 1 ______7 Sessions a week $400.00 Option 2 ______5 Sessions a week $350.00 Option 3 ______4 Sessions a week $300.00 Option 4 ______3 Sessions a week $250.00 Option 5 ______2 Sessions a week

Costume Deposit: Costumes will not be ordered unless they are paid in full You may include a costume deposit check for $50.00 with the remaining balance due on or before November 17, 2017. Or you must pay in full on or before November 17, 2017.

Sessions filled on a first come first serve basis. Private/Semi Private lessons are available at an additional cost. Iverson Skating Academy has the right to cancel any classes that do not fill up. Payment, registration forms, emergency permission form and waiver forms are due on or before October 13, 2017. You can pay in full by October 13, 2017 or you can make two payments. You must include, a post dated check for January 1, 2018 if you are paying in two installments. No refunds after the closing date of October 13, 2017.

Make check payable to: Iverson Skating Academy Option: ______$ ______5857 Hwy 73 Costume Deposit: $ ______Chisholm, MN 55719 Total: $ ______