Learn to Skate - First Strides
Inquiry Form
Parents/Guardian Information
Parent/Guardian Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Player Information
(1 player per form)
Player Name
*
First Name
Last Name
Date Of Birth
*
-
Month
-
Day
Year
Date
Age
*
Division
*
Please Select
Learn To Skate - First Strides - Sunday 2-3pm
Youth Hockey - Learn to Play - Sunday 2-3pm
Youth Hockey League (Ages 8-16) -n Sunday 3-4:30pm
Experience Level:
*
Please Select
First Time
Beginner
Intermediate
Advanced
Shirt/Jersey Size
*
Please Select
Jr Small
Jr Medium
Jr Large
Jr XL
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XXL
Where did you hear about us?
*
Please Select
Website
Facebook
Instagram
School
Friend
Family
Repeat Customer
Public Skate
Other
Additional Questions or Comments/Food allergies?
Please let us know if you have any other Questions or Comments!
Would you or someone you know be interested in joining our CCSA Rage Volunteer group?
Administrative
Reffing
Scorekeeping
Coaching
Snacks
Boardmember
Not Interested
Other (Please enter interest here)
Thank you! - CCSA Team
Address: 937 South Thornburg, Santa Maria, Ca. 93458 Gate #7 Phone: 805-868-3035
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