Save with 2 Day Pkg! Biggest Savings with 3 DAY Pkg!

/ PO Box 85,
Grimsby, ON,
L3M 4G1 / GRIMSBY SKATING CLUB
REGISTRATION FORM 2017/2018
Last Name: / First Name:
Skate Canada#: / Home Club (if other then GSC):
Address: / Male:_____ Female:_____
Town/City: / Postal Code:
Telephone#: / D.O.B. D:____ M:____ Y:____
Email address: / Recreational______Competitive_____
Last Badge passed: Badge______
Last Test passed:Freeskate______Dance______Skill______Interpretive______
Please indicate if there are any medical conditions that may limit your child’s participation in our programs:
______
ICE SCHEDULE
***Please check appropriate sessions below***
Sessions run from September to the end of March
Mondays /  / Thursdays /  / Saturdays / 
5:10-6:10 - Junior (*15 min group) / 4:00-5:30 - Junior(*15 min group) / 12:10-1:30 - Intermediate (*15min group)
6:10-6:55- Canskate /CanSkate for Hockey / 5:20-6:05- StarSkate (*45 min group) / 12:10-1:30- Senior (*15min group)
6:10-6:55- PreCanskate / 6:05-6:50- Canskate/CanSkate for Hockey / 1:30-2:15– Canskate/CanSkate for Hockey
6:10-6:55- Parent & Tot / 6:05-6:50- PreCanskate / 1:30-2:15- PreCanskate
6:55-7:05 - Flood / 6:05-6:50- Parent & Tot / 1:30-2:15- Parent & Tot
7:05-7:50- StarSkate(*45 min group) / 6:50-7:00 - Flood / 2:15-2:25 - Flood
7:35-9:00 Intermediate (*15min group) / 7:00-8:30 - Intermediate (*15min group) / 2:25-3:25 - StarSkate(*45 min group)
7:35-9:00 Senior (*15min group) / 7:00-8:30 - Senior (*15min group) / 3:00-4:00- Junior (*15 min group)
7:05-7:50 AdultSkate

Save with 2 day Pkg! Biggest Savings with 3 DAY Pkg!

Program / 1 Day / 2 Day / 3 Day / Total
CanSkate/PreCanskate/CanSkate for Hockey / 250.00 / 390.00 / 490.00
Parent&Tot / 288.00 / 428.00 / 528.00
Starskate Advantage / 475.00 / 595.00
Junior Freeskate / 295.00 / 605.00 / 755.00
Intermediate Freeskate / 315.00 / 625.00 / 775.00
Senior Freeskate / 315.00 / 625.00 / 775.00
Adult Skate / 190.00
Skate Canada Safe Sport Fee / 3.00
Skate Canada Fee (per skater) **Associate members must purchase a minimum 1 day package** / 35.00
Total Due **All cash/cheques must accompany registration form including volunteer bond** / $
Grimsby Volunteer Bond (Post dated cheque dated March 29,2018, returned upon completion of volunteer work at the season’s end) – must be a separate cheque; registration form will not be accepted without this bond. / $

50% must be paid in full at time of Registration – the balance is due by 1 postdated cheque – 50% postdated for November 15, 2017

We reserve the right to move skaters if sessions are full. Preference given to full package skaters. Sessions subject to change.

RELEASES
I, ______, consent to (skater’s name)______participating in the activities of the Grimsby Skating Club and hereby release and forever discharge the Grimsby Skating Club and its agents, being all coaches, directors, officers, volunteers, members, staff successors and/or assignees of and from all claims, damages, actions or causes of action arising by reason of the participation of (skaters’s name)______in skating or other club activities and from all claims or demands whatsoever in law or in equity which I, my heir, executors, administrators or assignees can, shall or may have because of such participation.
______
(signature of parent) (signature of skater if 18 or over)
______
(print name) (date)

HARNESS WAIVER

I, ______give permission for my daughter/son ______to use the harness at the Grimsby Skating Club. I understand that the Grimsby Skating Club will not be held liable for any injury that may occur while using this device.
______
(signature of parent) (signature of skater if 18 or over)
______
(print name) (date)

PUBLICATION

I, ______give permission for my daughter/son ______to have their photograph taken and to have their name and likeness published in local media, club social media /web site, club bulletin boards and/or newsletters and in any Skate Canada publications in recognition of their participation and accomplishments at the Grimsby Skating Club.
______
(signature of parent) (signature of skater if 18 or over)
______
(print name) (date)
For Office Use Only
Deposit (50%) / $ / Cheque#
Balance Deposit (50%) / $ / Cheque#

3rd+ family member 25% offlowest $ registrations

/ $
Volunteer Bond / $50.00/$150.00/$250(level dependent) / Cheque#
*** Per Skate Canada - All Skaters up to CanSkate Stage 6 must wear a CSAapproved hockey helmet ***
GSC REFUND POLICY
First Time New Skater (generally PreCan/Canskate/CanPower/Parent&Tot):
During the first 3 weeks a parent may request a refund from any Board Member at the Canskate table. All fees less the $38 Skate Canada Fees will be refunded. After 3 weeks, please see below.
All other GSC Members:
Fees will not be refunded if a member leaves the club, unless it is for medical reason. A letter to the GSC Board requesting refund with a Doctor's certificate is required. Refunds will be prorated and a $25 administration fee will apply. Skate Canada fees will not be returned under any circumstances.
I have read and understand the GSC Refund Policy and the Skate Canada Helmet Policy: X______