States & Spring Cup 2022 Entry Form

Date at 01/07/2022 ***THIS IS HIDDEN ON FORM***

Date

Skater name *

First Name Middle Name Last Name

Skater DOB *

Please select the skater's DOB

Skater age at 01/07/2022

Skater partner age at 01/07/2021

Coach name *

Skating division *

Skater's current test level *

Skater mobile number *

Skater or Parent or Guardian email address *

example@example.com

I have approval from my coach to enter State Championships or Spring Cup 2022 *

Yes

Skater state association *

SAISA WAISA ACTISA NSWISA ISQ ISV FSATAS

Affiliated club *

Music details: title(s) and artist(s) *

PAYMENT

Payment is by electronic funds transfer or over the counter deposit

BSB: 105-105
ACC: 389 743 040

Please add an easy identifier such as name and 'membership' or mobile number, birthday if only numerals are allowed.

Entry is not complete until payment has been made and is visible in the account

Division		Entry Fee ($ per skater)
Aussie Skate		115
Synchronized		95
Singles: Adult Preliminary Elementary Basic Novice Intermediate Novice Intermediate (ISA)		170
Advanced Novice Junior Senior		200
Family Discount	Second skater Third skater	Less 25 Less 35

Declaration

I agree to abide by the rules of this competition, of SAISA Inc and ISA Inc. I confirm that I meet the age test and eligibility requirements to enter this event.

SAISA Code of Conduct

Please click and read the SAISA code of conduct here

I have read and agree to the terms of the SAISA code of conduct *

Yes

I agree that either I or someone I nominate will volunteer to help with the competition when requested. You will be contacted via your, or your parent/guardian email address *

Yes

State Championships & Spring Cup 2022 Entry Form