SYR Speed Skating Membership Form 2022

2024 - 2025 Membership Registration

Syracuse Speed Skating welcomes you to the 2024 - 2025 season!
US SPEEDSKATING MEMBERSHIP

All club skaters, coaches, and board officers must be members of US Speedskating for insurance purposes. Go to US Speedskating and click on Become a Member to join. Or click on Member Login to renew your membership for this season.

CLUB LOCATION AND SCHEDULE

All practices take place at Sunnycrest Ice Rink, 699 Robinson Street, Syracuse 13206

Practices are Tuesdays and Thursdays 5:15-6:45 pm from November until last week of March.

No practice on November 28 (Thanksgiving), December 24 & 26 (Christmas Week), and December 31 (New Year's Eve).

SKATING AND MEMBERSHIP FEES

Club Membership

$350 for one night per week

$600 for two nights per week

*All Club members must also be members of US Speedskating

Skate Rental

Skate rental is available for $75 per season. Must be paid in full along with a $50 deposit before skating. Deposit will be returned to you at the end of the season upon return of skates in acceptable condition.

Free Try Speedskating

The first Tuesday of every month invite friends to try speedskating for free.

* Must complete US Speedskating 1 day 1 dollar form.

Refund Policy

Skating and skate rental fees are non-refundable

Athlete Information
Athlete's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Birth Date*

MonthDayYear
USS Membership Number*
USS Membership Expiration date*

MonthDayYear
_____________________________________________
In case of emergency please contact:*
Phone Number*

Area CodePhone Number
Relationship*
_____________________________________________
I will be renting club skates*

YesNo
_____________________________________________
Add additional athletes in the same family*

YesNo

Additional Athlete Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
USS Membership Number*
USS Membership Expiration date*

MonthDayYear
I will be renting club skates*

YesNo
Add additional athletes in the same family*

YesNo

Second Additional Athlete's Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
USS Membership Number*
USS Membership Expiration date*

MonthDayYear
I will be renting club skates*

YesNo
Add additional athletes in the same family*

YesNo

Third Additional Athlete's Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
USS Membership Number*
USS Membership Expiration date*

MonthDayYear
I will be renting club skates*

YesNo
Add additional athletes in the same family*

YesNo

Informed Waiver Consent and Acknowledgement

NOTE: THIS FORM MUST BE READ AND SIGNED BEFORE THE PARTICIPANT IS PERMITTED TO TAKE PART IN THE SYRACUSE SPEEDSKATING CLUB practices in the 2024-2025 Season at Sunnycrest Ice Rink, Syracuse, NY. BY SIGNING THIS AGREEMENT, THE PARTICIPANT AFFIRMS HAVING READ IT.

IN CONSIDERATION of my involvement in the sport and activities under the auspices of U.S. Speedskating and Syracuse Speedskating Club (SSC), I acknowledge, appreciate, and agree that:

1) I RISK BODILY INJURY, INCLUDING PARALYSIS, DISMEMBERMENT, DISABILITY AND DEATH AND while particular rules of my sport, equipment, and persona training and discipline may reduce this risk THIS RISK OF INJURY DOES EXIST, AS WELL AS THE RISK OF DAMAGE TO OR LOSS OF PROPERTY;

2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS; both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERS;

3) In the event of a serious illness or accident, I authorize the Syracuse Speedskating Club, or their designee, to approve any necessary emergency medical treatment to myself or my son/daughter, while he/she is training with the Syracuse Speedskating Club. I also authorize the Syracuse Speedskating club or their designee to provide the foregoing information to medical personnel for the purpose of providing such medical treatment. I agree to release and hold harmless the Syracuse Speedskating Club, its coaching staff, its officers, and members from any liability arising out of or as a result of the provision or use of the foregoing information and the provision of an emergency medical treatment to myself/child/or children.

4) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual or unnecessary hazard during my presence or participation, I will bring such to the attention of the nearest coach or club official; and,

5) I, FOR MYSELF, AND ON BEHALF OF MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES, and NEXT OF KIN, HEREBY RELEASE, HOLD HARMLESS, and PROMISE NOT TO SUE US SPEEDSKATING, Syracuse Speed Skating Club, Sunnycrest Ice Rink, City of Syracuse, NY, THE INTERNATIONAL OLYMPIC COMMITTEE, THE UNITED STATES OLYMPIC COMMITTEE, THE INTERNATIONAL SKATING UNION OR OTHER SPONSORING ORGANIZATIONS, THEIR OFFICIALS, VOLUNTEERS, STAFF, SPONSORSORS AND/OR AGENTS (“RELEASEES”) WITH RESPECT TO ANY AND ALL INJURY AND LOSS ARISING FROM MY PARTICIPATION, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, EXCEPT THAT WHICH IS THE RESULT OF GROSS NEGLIGENCE OR WANTON MISCONDUCT.

6) I further undertake to skate safely and wear protective equipment at all times. All skaters must wear an ANSI/SNELL certified helmet, cut-resistant neck guard, knee pads, and full-fingered gloves.

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 BELOW 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 legal guardian if athlete(s) is a minor:

First NameLast Name
Contact email:

Please be sure to select the correct quantity for the number of skaters you are registering.
My Products
prevnext( X )
One Night$350.00

Quantity

Two Nights$600.00

Quantity

Donation$10.00
Our club is a 501(c) charity. Financially, our goal is to break even every year. Our expenditures include ice time, equipment purchases and other small expenses. If you wish to make a donation in support, it will be greatly appreciated. Please choose any quantity in $10 increments.

Quantity

Total $0.00
Should be Empty:

2024 - 2025 Membership Registration