ACTISA 2025 Membership Form

PLEASE READ THESE INSTRUCTIONS BEFORE COMPLETING THIS FORM

FOR AUSSIE SKATE, ALSO REFER BELOW FOR MORE INSTRUCTIONS

This must be completed by all individuals applying to ACTISA for membership.
One form per person
Refer to the ACTISA Membership Policy Document for full membership information.
Payment must be made via bank transfer using the details below.
- Direct Deposits to St George Bank
- Account: ACT Ice Skating Association Inc
- BSB: 112-908
- Account Number: 482 330 765
This is only form of electronic payment available at this time.
In the comments field enter [LAST NAME][FIRST NAME]2025 Mship
Preferably separate payments for each applicant.
If possible add an email copy to ACTISA.Judge@gmail.com
If not possible, email the applicant details, date and receipt number to ACTISA.judge@gmail.com
For printed forms or payment with cash, email ACTISA.judge@gmail.com
Please DO NOT leave cash in the ACTISA drawer at the rink.

Last Name*

First Name(s)*

Street Address or PO Box Number*

Suburb*

Territory/State*

Post Code*

Email Address*

example@example.com

Phone No*

Date of Birth*

Date

ACTISA Member No

Proof Age Number

Renewing members can find their ACTISA Member and Proof of Age Numbers at the link below:

https://www.jotform.com/grid/250840732945056

The Last Name can be sorted at the top of the column by double clicking or using the down arrow.

There is a search function at the bottom.

New members will be assigned an ACTISA member number after processing.

ALL applicants aged 18 and over are asked to upload a current Working With Vulnerable People card or equivalent evidence. (Maximum 10.6 Mb)

AUSSIE SKATE ONLY

Please pay NEW and renewing Aussie Skate Registrations directly with ISA using the link below FIRST.

https://aussieskate.au/

Click on Registration at the top of the page, then Registrations at the right. Login if you have an account or create a new account. Make sure you choose the ACT membership.

For those who were Aussie Skate members from 2024 and earlier but did NOT register with ISA at the time, email aussie.skate@isa.org.au with your details and for instructions on how to renew rather than join up for the first time. This way you will not pay the new member price.

Anyone who did register with ISA last year should have received an email. If you did not, then make contact at aussie.skate@isa.org.au.

Note that Aussie Skate fees are payable to ISA every year regardless of when you joined.

Date of registration and payment to ISA

Date

Banking receipt or transaction number of payment to ISA

Option 1: Aussie Skate NEW member - $15Option 2: Aussie Skate renewing member - $5 fee

Senior member (18 years and over) - $50 feeJunior member (under 18 years) $50 feeAssociate member (non skating) $50 feeHonorary Life member $0 feeComplementary Associate member (ACTISA approved only) $0 fee

Note that all NEW members joining from October to December 2025 will remain financial until 31 December 2026. Previous Members who renew at any time in 2025 will remain financial until 31 December 2025 This only applies to the ACTISA Membership fee, NOT the Aussie Skate registration fee which is paid directly to ISA.

Except for Aussie Skate, all fees include compulsory levy for annual registration with Ice Skating Australia Ltd.

Additional information:

Photograph/s and/or films taken under ACTISA's direction, at ACTISA events, by a designated photographer/video operator plus any film footage provided from different sources (under ACTISA's direction) may be used by an ACTISA committee official to formulate information for distribution to the media, for placement onto the ACTISA official website and/or for use in any promotional material directly relating to ACTISA and/or ice skating in the ACT.

ACTISA will send routine emails regarding forthcoming competitions, events and statutory notices.

For any concerns regarding the above, contact ACTISA.pres@gmail.com

Mandatory Agreement:

This is an important document and you should read it carefully before signing it. Upon signing or submitting this membership application or renewal, you acknowledge that you have read, understood and agree to be bound by and comply with all Ice Skating Australia policies which can be found here - Policies & Protocols – Ice Skating Australia | Official Website (isa.org.au). You are responsible to be familiar with these policies, and a breach of these policies could result action being taken against you, as outlined in the complaints or discipline procedures for the respective policy. You also acknowledge that you are bound by and must comply with all ACT Ice Skating Association policies and procedures, and that a breach of these could also result in action being taken against you.

Where the applicant is under 18 years of age, the applicant’s parent or guardian:

1. consents to the applicant being bound by all Ice Skating Australia policies and ACT Ice Skating Association policies and procedures;
2. agrees to being responsible for the applicant’s behaviour;
3. agrees to be bound by and comply with Ice Skating Australia’s policies and ACT Ice Skating Association policies and procedures; and
4. acknowledges that a breach of these policies could result in action being taken against you, as outlined in the complaints or discipline procedures for the respective policy.

As the signatory below, I acknowledge that I have read the above and agree that I/the applicant will abide by the Constitution, Rules, By-Laws and Policies & Procedures of ACTISA (www.actisa.asn.au) and Ice Skating Australia (www.isa.org.au)

Name of Applicant or Parent/Guardian if under 18 years or a vulnerable person#*

Relationship to Applicant or Parent/Guardian if under 18 years or a vulnerable person#

#As the parent/guardian named above, do you accept complementary Associate membership for the sole purpose of voting on behalf of the applicant on this form? (Maximum of one per applicant and maximum two per family of two or more members under 18 years.) Note that unless the applicant is a vulnerable person, if they reach 18 years old during the membership year, voting rights for the parent/guardian will expire.

YesNo

Signature of Applicant or Parent/Guardian if under 18 years or a vulnerable person*

Date

ACT ICE SKATING ASSOCIATION INCORPORATED (ACTISA)

MEMBERSHIP FORM 2025

APPLICANT DETAILS