SkateDay Registration

THE HEIGHTS SKATE CLUB SKATE DAY-NOVEMBER 3, 2022

PARTICIPANT REGISTRATION

First Name*

Last Name*

Birthdate*

Birthdate mm/dd/year

Level*

Beginner Intermediate Advanced Advanced/Sponsored

PARTICIPANT INFORMATION

Street*

City*

State*

Zip Code*

PARENT INFO (If Participant is under 18 years old)

Parents Name*

Parents E-mail*

Parents Cell Phone*

703-555-1212

Parents Emergency Phone*

703-555-1212

Click Here to Read Release and Participation Agreement

I give my son permission to participate. I have read and accept the release and agreement .

(Parent) Yes, I Agree

Parent Signature

Use your mouse or finger to draw your signature above