Completed Form with payment to:
LEARN TO SKATE – REGISTRATION FORM
Location of Class:
Day: Date: Time:
Child’s Name: Age: Day Month Year
Address: Postal Code:
Phone: Home: Work./Cell:
Community you reside in: Community Membership #
Signature of Parent/Guardian: Print Name:
HELMET WITH FULL FACE GUARD IS MANDITORY FOR ALL CHILDREN
Would you be willing to help with the first 1 or 2 lessons, until your child can get up on their own?
Drop off completed form with payment at the West Zone Board
office. (Mail slot beside door.)
DO NOT MAIL
Payment is required at time of registration. Cheque or
Please make cheques payable to
West Zone Board. All returned cheques are subject to a $25.00 Service Charge.
COST: $85 plus $10 for Community Membership or include your membership number above.
REFUND POLICY: If a Program is cancelled by the
Zone Board – the full fee will be refunded. Registrants
wishing to withdraw from a Program must make request in writing before the 3rd meeting of the Program.
Refunds (minus $10.00 Administration Fee) may be issued as a "Letter of Credit" towards a West Zone Board
Program (at the executive's discretion) expiring 1 year from issue date. Refund requests received after the
3rd meeting of the program cannot be processed - even if you have not attended the Program.
West Zone Board Use
Received From: Date:
Membership: $ Cash [ ]
Cheque [ ]