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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