Team Image 2017-18 Registration Form
Please fill out the registration form as fully as possible before attending any clinic or tryout
Beginner $30/Session - $90 for all Sessions
Preliminary thru Novice $50/ Session - $125 for all sessions
Please bring a check, payable to TEAM IMAGE, to your first clinic
New Skaters - Please bring a headshot
Skater's name
Your answer
Skater's Date of Birth
Your answer
Age as of 7/1/17
Your answer
Street Address
Your answer
City, State, Zip Code
Your answer
Phone Number
Your answer
Mother's Name
Your answer
Mother's Cell Phone
Your answer
Father's Name
Your answer
Father's Cell Phone
Your answer
Family Email Address
Your answer
Skater's USFS number
Your answer
Skater's ISI number
Your answer
Previous Synchro Experience
Team Name
Your answer
Level Skated
Your answer
Years on Team
Your answer
USFS Testing Levels passed
Basic Skill or Freestyle
Your answer
Freestyle
Your answer
Moves in the Field
Your answer
Dance
Your answer
Lessons and Practice Information
Private Lesson Coach
Your answer
Coach Email
Your answer
Home Rink
Your answer
Lessons per week
Your answer
Duration of practice per week
Your answer
Waiver of Responsibility
In consideration of being permitted to audition for Team Image SST, and understanding that there are inherent risks of injury in connection with skating and ice-related activities, I hereby acknowledge and assume all responsibility for these risks and waive any and all possible claims that may arise against the Yonkers Figure Skating Club, Team Image SST, EJ Murruay’s Skating Center, The City of Yonkers, Hommacks, Playland Ice or Westchester Skating Academy in connection with the audition and my (our) use of the facility. I represent that I am the parent or legal guardian of the skater, of lawful age, and legally competent to sign this release. By answering below I certify that I have read and fully understand the conditions herein provided.
Name of person filling out form
Your answer
I have read and fully understand the conditions herein provided.
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