KWSSSC Guest Skater Registration Form 2019-2020
This is the official registration form for Guest Skaters at the Kitchener Waterloo Sertoma Speed Skating Club (KWSSSC).
We ask that you please take time to fill out the form accurately and thoroughly.
This form must be filled out once for each Guest Skater at KWSSSC.

NOTE: You must have permission from your home club's coach and the lead KWSSSC coaches to skate with our program.
If you haven't already secured permission to Guest Skate with the KWSSSC, please have your coach send an email to coach@kwspeedskating.com requesting permission for you to Guest Skate with the KWSSSC.
Email address *
Please Note: the Email Address provided above should be the preferred email address of the main contact of the Family to which the KWSSSC Guest Skater belongs (Note: if the Guest Skater is 18 years of age or younger, the email address submitted here MUST belong to a Parent or Guardian and MUST NOT belong to the youth Guest Skater)
Guest Skater's Name *
Your answer
Name of the person filling out this Registration Form *
Your answer
Guest Skater's Home Club *
Your answer
Guest Skater's Coach *
Your answer
Guest Skater's Coach's Email Address *
Your answer
Guest Skater's Birthdate *
MM
/
DD
/
YYYY
Guest Skater's age as of July 1, 2019 *
Your answer
Guest Skater's Street Address (please include Unit number if applicable) *
Your answer
Guest Skater's City of Residence *
Your answer
Guest Skater's Postal Code *
Your answer
Guest Skater's Family's Preferred Phone # *
Your answer
This Skater has permission to Guest Skate at the KWSSSC from their home club's head coach. Please have your coach email coach@kwspeedskating.com to confirm. *
This Skater has permission to Guest Skate at the KWSSSC from the lead KWSSSC coach for the skating group the Guest Skater will join. *
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