Ice Diamonds Tryout Registration
Skater Information
Skaters' First Name *
Your answer
Skaters' Last Name *
Your answer
Home Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone # *
Your answer
USFSA # *
Your answer
Home Skating Club *
Your answer
Date Of Birth *
MM
/
DD
/
YYYY
Skater's Grade in School (for the 2018-2019 school year)
Skater's Email *
If skater does not have their own email address, type NONE.
Your answer
2017-2018 Ice Diamonds Skating Team *
If you skated on a team other than the Ice Diamonds in 2017-2018, please provide the team/organization name and level skated:
Your answer
Individual Coaches Name *
If you are in Learn to Skate group lessons, please put N/A
Your answer
Individual Coaches Email *
If you are in Learn to Skate group lessons, please put N/A
Your answer
USFSA Test Level Passed
Learn To Skate Level Passed (for Synchro Skills skaters)
Your answer
Moves In The Field Passed *
Free Skate Passed *
Dance Passed (all three Dances of the level) *
Skater Medical Information
If your skater uses an inhaler, do you give permission to keep the inhaler with your skater at the team activities and to use it as needed? *
If your skater uses an Epi-Pen, do you give permission to keep the Epi-Pen with your skater at the team activities and to use it as needed? *
Does your skater have any allergies? *
If yes, please explain your skater's allergies (e.g., foods, medications, animals or environmental factors), the severity of your skater's allergic reaction and any symptoms.
Your answer
How many concussions has your skater had in their lifetime? *
How many concussions has your skater had in the past 12 months? *
Does your skater have a medical condition or has your skater had an injury (other than a concussion) in the past 12 months? *
If yes, please explain the medical condition or injury.
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone # *
Your answer
Parent Information
- Please provide contact information for at least one parent.
- If both parents want to be included in Ice Diamonds
communications, please provide Parent 2 contact information.
Parent 1's Name *
Your answer
Parent 1's Cell Phone # *
Your answer
Parent 1's Email *
Your answer
Parent 1's Medical Training
Please check all that are applicable
Parent 2's Name
Your answer
Parent 2's Cell Phone #
Your answer
Parent 2's Email
Your answer
Parent 2's Medical Training
Please check all that are applicable
Volunteer Interests
Please check the Ice Diamonds Volunteer Opportunities in which you are interested in participating for the 2018-2019 season.
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