BASINGSTOKE ICE SKATING CLUB
IJS OPEN COMPETITION
ENTRY FORM
CLOSING DATE 10TH OCTOBER 2015 AT 2400 hrs.
A separate fully completed entry form is required for each event entered. Programme Content sheet & Skate UK Passport (see criteria and rules) must be submitted with the entry form and fee, and failure to do so will result in the entry being returned. Late & incomplete forms will not be accepted.
Competitors Name: NISA membership number:
Male/Female (delete as appropriate)Club/Rink:
Date of Birth:Class no (see criteria)
Age as at 10/10/15 -
Address:
Email address:
Phone no:
Highest NISA Tests passed
Field Moves/Dance Moves: Date passed:
Elements: Date passed:
Free: Date passed:
Competitive Test (Short)Date passed:
Competitive Test (Long)Date passed:
COACH 1:
Licensed Coach Name:
Licensed Coach NISA Membership No:
Date/ Venue/Conference IJS Seminar attended:
Date/Venue Field Moves Seminar attended:
COACH 2:
Licensed Coach Name:
Licensed Coach NISA Membership No:
Date/ Venue/Conference IJS Seminar attended:
Date/Venue Field Moves Seminar attended:
Please click on the boxes to indicate that the following have been included:-
Entry form & Programme Content Sheet:☐
Skate UK Passport(copy required if Level 1 Field Moves/Level 1 Dance Moves have not been passed, see criteria: ☐
Emailed to : ☐please ensure all documents are attached to the same email
Or posted to:- Mrs. M. Kershaw, 2 Seaview Cottage, Monks Lane, Freshwater, Isle of Wight, PO40 9SU. ☐
Payment:-
Fee per class - £55 non-member of Basingstoke Ice Skating Club☐
Fee per class - £50 full member of Basingstoke Ice Skating Club ☐
PayPal☐credit card ☐debit card ☐(via
Cheque☐Postal Order☐(sent with entry form to above postal address)
For all enquiries, please email Maureen Kershaw:-
I understand and accept that anti-doping testing may take place during this event. I will make myself available at the time and place advised, if selected. If under 18 - I parent/guardian of above skater under 18 years, agree to give the appointed officials my permission to test the skater entered in the above competition, if so selected.
I am an eligible skater as defined by NISA. I have read the rules of the competition & agree to abide by them.
I agree that the information provided may be stored on computer for use of Basingstoke Ice skating Club in preparing for Open Competitions.
I do/do not grant permission for the skater to be filmed/photographed during the competition for the purpose of DVD sales.
I understand that receipt of payment and entry documents does not guarantee entry into the Open.After the closing date the Referee will decide on the numbers per class that can be entered into the Open & unsuccessful Competitors will be notified accordingly and the entry fee only will be reimbursed.
Signed parent/guardian if skater is under 18 years.
FOR BISC USE ONLY
Date received
Entry form completed ☐
Content sheet completed☐
Skate UK Passport signed☐
Payment method cheque ☐p.o☐paypal ☐credit card ☐debit card☐
Other☐