Learn to Skate Registration Form: Session__________________

Snowplow Sam, Basic 1-8, Adult 1-4, Freeskate 1-6 

Name________________________________Sex: M / F  Birthdate:______________

Address___________________________________Age___________

City______________________________State________ Zip______________

Email_____________________________________(print clearly)

Parent / Guardian name_____________________________________________

Phone _____________________(H)  _________________________(W)

Class Level___________________________Class Day_________________

New Enrollment                      $93.00 __________

Friday Home school class       $86.00 __________ (10% discount)

Reenrollment                           $93.00 __________  

US Figure Skating Basic Skills fee $7.50    _________

Mid session  (call for prices)               __________

Walk on       (one class only)   $18.00 __________   

Make Checks available to THE CAROLINA ICE PALACE.

Prices and schedule subject to change. All fees are NON-REFUNDABLE. 

Acknowledgment of Risk & Waiver

As the legal parent or guardian for the student registered in the Learn to Skate Program, I hereby consent to the child’s participation in the aforementioned program. I recognize that there are certain inherent risks associated with the activity of ice skating and acknowledge that the Carolina Ice Palace is not liable for an injury to or the death of a skater resulting from an inherent risk of skating. “Inherent risks” means those dangers which are an integral part of ice skating including and not limited to, injuries from incidental contact with other skaters, injuries which result from falls caused by loss of balance, and injuries which involve objects or artificial structures within the intended path of travel of the skater.

 I also agree to release the Carolina Ice Palace, LLC and J&A Associates, their directors, officers, owners, instructors, employees and agents from all liabilities and claims I or the named student may hereinafter have for all injuries, damages or expenses sustained by the student or his or her property.

 I certify that I am aware of the risks associated with ice skating. This registration agreement and acknowledgment of risk and waiver of liability having been read thoroughly and understood completely, is signed voluntarily as to it’s content and intent.

 Date_______________ Parent / Guardian signature____________________________