Lakeshore Skating Academy Registration Form
PLEASE NOTE: WE ONLY TAKE CHECK OR CASH. THE RINK WILL NO LONGER BE TAKING PAYMENT FOR LAKESHORE SKATING ACADEMY. CHECKS PAYABLE TO LAKESHORE SKATING ACADEMY.

Come learn to skate with Lakeshore Skating Academy. Come have fun and make memories that will last a lifetime! Our program is registered with Learn to Skate USA.

Ages 3+
Skate Rental INCLUDED

Email address *
Skater's name *
Your answer
Middle Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City, State, Zip Code *
Your answer
Home phone/Cell phone *
Your answer
Sex *
Skater's Birthday *
Your answer
Skater's Age *
Your answer
US Citizen *
Emergency Contact *
Your answer
Allergies *
Your answer
Anything you would like to add? *
Your answer
Please select one *
Session Enrolling Check payable to: Lakeshore Skating Academy (may bring payment to 1st class) *Please select class/classes carefully* *
How did you hear about us? *
Your answer
Waiver By placing my initials, I agree to the terms and conditions of this waiver. Acknowledging that ice skating can be hazardous, I agree that Lakeshore Skating Academy, its agents, servants and employees shall not be liable to me (my child) for any injury or damage, howsoever caused, resulting directly or indirectly from me (my child’s) participation in ice skating, whether incurred on the ice or otherwise in or about the building at any time preceding during or subsequent to the delivery of the program and I hereby discharge Lakeshore Skating Academy, its agents, servants, and employees from all actions, claims, and demands in regards to me (my child) for any injury and damage, howsoever caused, incurred in or about the residence of buildings at any time during the term of the program. I also understand and agree that no portion of my (my child’s) registration fee will be refunded to me (my child) in the event, for whatever reasons, I (my child) withdraw from the Lakeshore Learn to Skate. I further acknowledge and agree that Lakeshore Skating Academy does not insure and will not be expected at any time, to insure the safety or the proper state of repair of my (my child’s) equipment used by me (my child) during the program and that Lakeshore Skating Academy does not, and shall not, be considered to guarantee or warrant the program material used by it during the program. I also acknowledge and agree that Lakeshore Skating Academy reserves the sole and exclusive right to use any photographs taken during the program for advertising and/or instructional purposes, without cost or charge whatsoever to Lakeshore Skating Academy. I also understand that my agreements, releases, and discharges herein shall bind my heirs, legal representatives and assigns and shall inure to the benefit of Lakeshore Skating Academy, its agents, servants and employees, and their successors and assigns. *
Your answer
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