Renfrew Skating Club
P.O. Box 872 Renfrew, Ontario K7V 4A6
Email address *
Name of Skater *
Your answer
Please select the level your child will be playing during the 2019-2020 season *
Sex *
Date of birth (d/m/y) *
Your answer
Address *
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Postal Code *
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Township *
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Mother's Name *
Your answer
Mother's Phone Number *
Your answer
Father's Name *
Your answer
Father's Phone Number *
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Emergency Contact (other than parent) *
Your answer
Emergency Contact Phone Number: *
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Does your child suffer from allergies? *
Your answer
Does your child carry an epipen? *
Does your child have special needs?
Your answer
The Renfrew Skating Club may use photos for publicity, such as the website and newspaper to generate awareness of our sport and acknowledge skaters achievements. Unless you select "OPT OUT", we may include your skater's name and image. *
Method of Payment *
Fees and Schedule *
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Times: *
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Waiver *
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