Request edit access
ICE Camp Registration
Register here for 2017 Winter ICE Camp.
(Please submit separate form for each additional child.)

NOTE: We'll send an informational email a few days prior to your registered week(s)

First Name *
(Child)
Your answer
Last Name *
Your answer
Phone Contact *
(during program hrs.)
Your answer
Email Contact(s) *
For camp information and notices
Your answer
School
(SY 2017-18)
Your answer
DOB *
(Campers must be 1st Grade & up)
MM
/
DD
/
YYYY
Male/Female
Select Week *
Check website for weekly location(s): Fort Dupont Ice Arena or Canal Park rink
Required
Ext. Day Program
Let us know if you'll need AM or PM Ext. Day (additional fee)
Transportation Service
Let us know if you'll need AM pick-up or PM drop-off (additional fee)
Partial Week
Only need us for part of a week? Schedule changes by the day? Let us know about it...
Your answer
Health / Other
Is there anything we need to know that may affect your child's experience at ICE Camp? (I.e., allergies; medications, etc.)
Your answer
Shoe/Skate Size
(Skates provided, if needed)
Skating Experience
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
Please bring fee on first program day. Cash or check payable to 'DC-ICE'.
Interested in Jr. Coach/Leadership program?
(By invitation: Ages 14-15 only - some exceptions for advanced 13 y.o. skaters.)
Submit
Never submit passwords through Google Forms.
This form was created inside of Inner City Excellence (ICE). Report Abuse - Terms of Service - Additional Terms