Pivots and Paws Skater Registration
Event Timing: Saturday, November 25, 2017 from 5:45-8:30pm
Event Address: Cary Ice House
1410 Buck Jones Road
Raleigh, NC, 27606
Contact Katherine Xing at 919-257-0560 or kxing1415@gmail.com

- I can only take a limited amount of skaters, therefore it is a first come first serve basis.
- I will contact you and your parent via email by October 20 if you are given a spot.
- A 15 minute practice ice will be provided. Please arrive early to warm up. Schedule will be given out soon.

Name (Last, First) *
Your answer
Cell phone I can reach you at *
Your answer
Email I can reach you at *
Your answer
How long is your program? (limited to 1) *
Your answer
Parent/Guardian Phone Number *
Your answer
Pairs, Dance, Synchro, or Singles skater? *
If pairs/dance, who is your partner?
Your answer
I understand as a singles skater, I will have to pay a 25$ entry fee, to be paid by November 10 if I am contacted on October 20. *
I understand as a dance or pairs skater, my partner and I will each have to pay a 10$ entry fee, to be paid by November 10 if I am contacted on October 20. *
I understand as a synchro skater, that my teammates and I will each have to pay a 10$ entry fee, to be paid by November 10 if I am contacted on October 20. *
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