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Skating Program Registration Form 2022

Please fill out this form and make payment by February 1, 2022.

Programs available: Toddler Learn to Skate (Ages 3-5 with Parental Assistance), Learn to Skate (Ages 6+) and Power Skating (must have excellent skating skills)

Lesson Dates: February 3, 10, 17 & 24, 2022 (see times below)

Maximum cost per family is $50

Parent/Guardian Name

Parent/Guardian Address

Phone Number

Emergency Contact

Phone Number

Participants Name:

Participants Date of Birth:

Medical concerns/allergies:

Program:

Toddler Learn to Skate (Ages 3 - 5 with Parental Assistance) - $20 for Season - Helmets MANDATORY - Thursdays 5:30 pm - 5:55 pm

Learn to Skate (Ages 6+) $25 for Season - Helmets MANDATORY Thursdays 6:00 pm - 6:55 pm

Power Skating (Must have excellent skating ability) $25 for the season. Full Hockey or Ringette Equipment is required. Thursdays 7:00 pm - 7:55 pm

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I, the undersigned, do hereby release and agree to indemnify and save harmless the Township of Greater Madawaska and their respective employees or agents from all claims for loss, injury or damage to persons and property while participating in or travelling to and from the activities, which I or any person claiming through me or on my behalf, may at any time have arising out of or connected with the operation of this activity.

Parent/Guardian Signaure

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Skating Program Registration Form 2022