Syracuse Speed Skating and Membership Form 2020-2021

Summer Ice Registration and Membership
US SPEEDSKATING MEMBERSHIP

All club skaters, coaches, and board officers must be members of US Speedskating for insurance purposes. Go to US Speed Skating Membership Registration to join.

SUMMER ICE SCHEDULE

Every Thursday June through August from 5:30-6:45 pm.

6/2, 6/9, 6/16, 6/23, 6/30, 7/7, 7/14, 7/21, 7/28, 8/4, 8/11, 8/18, 8/25.

Location:

Meacham Ice Rink, 121 W. Seneca Turnpike, Syracuse, New York.

LEARN TO SKATE & TECHNIQUE TRAINING

Sessions in June & August will be devoted to Learn To Skate and Technique Training. New skaters are welcome, current skaters are welcome to come and work on continuing skills.

All session in July (and September if ice is available) will be devoted to speed training in our traditional manner. New skaters are also welcome.

FEES

Option One: Join our summer ice membership and training program for a flat fee of $125. Includes all sessions through the end of Augst.

Option Two: Drop in skate sessions $20 per session.

SKATE RENTAL

Skate rental is available for the summer season for most boot sizes. If you are interested in skate rental, you must submit your shoe size AND fill out the separate skate rental form.

Athlete Information
Athlete's Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Birth Date *

Month Day Year
USS Membership Number *
USS Membership Expiration date *

Month Day Year
_____________________________________________
In case of emergency please contact: *
Phone Number *

Area Code Phone Number
Relationship *
_____________________________________________
I will be renting club skates *

Yes No
_____________________________________________
Add additional athletes in the same family *

Yes No

Additional Athlete Information
Athlete's Name *

First Name Last Name
Birth Date *

Month Day Year
USS Membership Number *
USS Membership Expiration date *

Month Day Year
I will be renting club skates *

Yes No
Add additional athletes in the same family *

Yes No

Second Additional Athlete's Information
Athlete's Name *

First Name Last Name
Birth Date *

Month Day Year
USS Membership Number *
USS Membership Expiration date *

Month Day Year
I will be renting club skates *

Yes No
Add additional athletes in the same family *

Yes No

Third Additional Athlete's Information
Athlete's Name *

First Name Last Name
Birth Date *

Month Day Year
USS Membership Number *
USS Membership Expiration date *

Month Day Year
I will be renting club skates *

Yes No
Add additional athletes in the same family *

Yes No

Informed Waiver Consent and Acknowledgement

In consideration of my participation in the Syracuse Speedskating Club, Inc. (SSC) or in any of its activities, I do hereby waive for myself, heirs, executors, administrators and assigns all rights and claims for damage I or we might have against the Club, its officers or members and assigns for any and all injuries and damages suffered by me while participating in, and traveling to, any club activity. This waiver applies equally to and for any minor listed below and/or that I may bring to any activity of the SSC.

I further undertake to skate safely and wear protective equipment at all times as spelled out in the Code of Conduct.

Covid-19 Consent and Waiver:

As a club member, I agree to comply with all club rules, US Speedskating recomendations and any and all facility policies regarding health and covid-19.

I understand that participating in social activities, including speedskating, during this time carries a risk of contracting and/or spreading covid-19. I do hereby waive for myself, heirs, executors, administrators and assigns all rights and claims for damage I or we might have against the Club, its officers or members and assigns for any and all injuries and damages suffered by me stemming from covid-19 while participating in, and traveling to, any club activity. This waiver applies equally to and for any minor listed below and/or that I may bring to any activity of the SSC.

Photography

I hereby grant the Syracuse Speedskating Club permission to use my likeness in photographs and/or video in any and all of its publications, including Web space, and in any and all other media, whether now known or hereafter existing, controlled by SSC, in perpetuity, and for other use by the SSC.
Confirmation

BY AGREEING ABOVE AND SUBMITTING THIS FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT IS EQUIVALENT TO AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
*

I Agree
Parent or guardian if athlete(s) is a minor:

First Name Last Name
Contact email:

My Products
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Summer Ice Membership $ 125.00

Quantity

Drop-In Skate $ 20.00

Quantity

Total $ 0.00
Should be Empty:

Summer Ice Registration and Membership