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Registration Forms
(etc.)

                    

 

PRE-REGISTRATION FOR SHANNON HEIGHTS SKATING CLUB  WINTER SESSION 2004/05

 

Skaterís Name: _________________________________

 

Address: ________________________________________

 

                _________________________________________

 

Email Address:______________________________________

 

Postal Code: ____________ Phone Number:____________

 

Date Of Birth: ____________    Sex: F or M

 

Health Card No.___________________________

 

Skate Canada No. _________________________

 

Test Passed

Dance:                                          Are you a member of The Military ________

Skill: ___________________     Spouse ____ Dependant   ____ Other  ____

Free:___________________     None of the Above ______

Interpretive: _____________ _______

 

 

I understand that my son/daughter will be registered as home club Shannon Heights unless I inform the executive otherwise prior to July 1st 2004. Please mail  form before June 15th.

Pre-registration is $25.00 per skater. ( Which is non-refundable)

 

Signature:_____________________________________

 

Please mail form to:  Kim LeBlanc

                                   21 Connolly Rd

                                   Lwr. Sackville, NS

                                   B4E 1S6