After-School Skating - Registration (SY 2019-20)
Register here for our after-school skating program.
(Please submit separate form for each additional child.)
First Name *
Last Name *
School *
(SY 2019-20)
Phone Contact *
(during program hrs.)
Email Contact *
(Must be in at least 1st grade SY 2019-20)
Male/Female *
After-School Program(s) *
Select one or more programs. You can add or delete later. (No obligation)
Day(s) of the Week *
(Skaters can change days or make up missed days on any other day, incl. Saturdays)
Transportation Service
Check to request school pick-up and/or home drop off - additional fees. [Note: Does not guarantee service. Please email to confirm whether we can pick up from your school on requested day(s).]
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?
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.
Fee & Payment information (10-week)
Please bring fee on first program day. Cash or check payable to 'DC-ICE'. (Fee amount does not include transportation)
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