Wallaceburg Skating Club Registration 2020-2021

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* 1. Name:

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* 2. Date of Birth (dd/mm/yy):

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* 3. Parent/Guardian Name:

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* 4. Street Address, Email & Phone Number

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Picture for reference only. Session days and times are subject to changes depending on interest/numbers.

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* 5. Select your choice below:

StarSkate Junior
Tuesday only: 5:00pm - 5:45pm
Group Lessons (coached)

StarSkate Junior
Thursday only: 5:00pm - 5:55pm
Group Lessons (coached)

StarSkate Junior (Both Nights)
Tuesday: 5:00pm - 5:45pm
Thursday: 5:00pm - 5:55pm
Group Lessons (coached)

StarSkate Senior
Tuesday only: 4:00pm - 5:00pm

StarSkate Senior (Both Nights)
Tuesday: 4:00pm - 5:00pm
Thursday: 4:00pm - 5:00pm

Private Lessons
Nights and times will be determined once interest / availability known.
Note: Please use comment box below to indicate day and time preference

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* 6. Optional: If you selected Private Lessons, please indicate your preferred day and time below.

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* 7. I agree to have photos and/ or name of above skater published in our newsletter/ program/ Facebook.

Yes