2008-2009 Fall/Winter Skating School Registration

ONE FORM PER CHILD 

Student Name: ___________________________________________________________________                           Birthdate: ___________________________________

Address: ________________________________________________________________________________________________________________________________

                                    Street                                                                                     City                                                                                                        Zip Code

Home Phone: __________________________________________   Sex:  Male    Female      Grade:_________________

IN ORDER FOR YOUR CHILD TO PARTICIPATE, SKATING SCHOOL

ACCOUNT MUST BE CURRENT. 

Payment is due at the time of registration or before a new session starts

Refund Policy: Cancellations will be assessed a $10 late fee per program.  Written notice must be received in the Business Office at least 7 calendar days before the program begins in order to receive a full refund.  Written notice received after 7 calendar days before a program is scheduled to begin constitutes a credit, which will be granted toward additional programming  for the student or a sibling during the current Skating School Year.  Refunds will be issued at the end of the skating in March.

Helmets are required for students ages 4 thru 9

ACTIVITIES PARTICIPATION AND EMERGENCY MEDICAL PERMISSION (Required)

____________________________________________________________                   ___________________________________     _____________________________

                 Parent(s)’ Name(s)    (Circle: Mr., Mrs., Ms., Dr.)                                                         Parent Business Phone                                            Mother         Father

____________________________________________________________                   _______________________________________________________

                              E-mail address (mother)                                                                                                                  E-mail Address (father)

____________________________________________________________                   ___________________________________

                                  Family Physician                                                                                                     Physician’s Phone

I consent to my child’s participation in the Fall/Winter Skating School.  I also consent to and authorize the provision of emergency medical treatment for my child until I can be contacted and agree to be responsible for the cost of the treatment.  Please notify the Skating School, in writing, regarding your child’s medical information that should be on file.

____________________________________________________________                     ___________________________________

Signature of Parent or Guardian                                                                                        Date      

In case of emergency, if parents are not available, call

____________________________________________________________              __________________________________                     _____________________________

                        Name                                                                                                      Relationship                                                                  Phone   

Mail registration and fee to:  University School of Milwaukee – Skating School

 Attention: Business Office
             2100 W. Fairy Chasm Road

 Milwaukee, WI  53217

For questions about classes, please contact Jill by phone at (414) 540-3306
For Billing questions, please contact Jennifer by phone at (414) 540-3315