After-School Skating - Registration (SY 2017-18)
Register here for our after-school skating program.
(Please submit separate form for each additional child.)
First Name *
(Child)
Your answer
Last Name *
(Child)
Your answer
School *
Your answer
Phone Contact *
(during program hrs.)
Your answer
Email Contact *
Your answer
DOB *
(Must be in at least 1st grade)
MM
/
DD
/
YYYY
Male/Female *
After-School Program(s) *
Select one or more programs. You can add or delete later.
Required
Day(s) of the Week *
(Skaters can change days or make up missed days on any other day)
Required
Transportation Service
(Check if you need school pick-up and/or home drop off - additional fee)
Shoe/Skate Size
(If needed)
Skating Experience
Health/Other Considerations
Is there anything else we should know that might affect your child's experience in our program?
Your answer
Program Waiver & Consent *
I certify that I am the person named below or the authorized parent or guardian of the child named below. I hereby agree to waive liability and hereby release any and all claims against DC Inner City Excellence (DC-ICE), its officers, employees and agents for injuries and damages of any nature whatsoever suffered by myself (and/or my child 18 years old or under, on whose behalf I am signing) in conjunction with any ICE program, whether on or off the skating surface and no matter whether arising in tort, contract or otherwise. If DC-ICE is found liable for injuries or damages, I agree that my sole and exclusive remedy will be against DC-ICE and not against any individual, regardless of fault. I acknowledge that ice and inline skating and other physical activities at camp involve risk of serious bodily injury. I fully accept and assume all risks and all responsibility for all losses and damages incurred as a result of my participation and for my child’s participation in these activities.
Required
Fee & Payment information (10-week)
Please bring fee on first program day. Cash or check payable to 'DC-ICE'. (Fee amount does not
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