2025 Comet Skippers Winter Workshop

2025 Comet Skippers Winter Workshop

The workshop, held January 25, 2025, will teach all levels of jump roping skills, for school-aged kids through adults. Skills in speed, single rope, Double Dutch, Chinese Wheel, and long rope will be taught by highly skilled jumpers.
Participant Information
Partipant Name*

First NameLast Name
School or Team *
If school/team not listed above, please let us know what school/team you are part of:
Grade
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Jumper Experience Level*

Basic (Little or no experience)ElementaryIntermediateAdvanced
Is this registration a gift (we will provide a printable gift certificate via email if yes)?*

YesNo
Parent/Guardian Information
Name*

First NameLast Name
Cell Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
E-mail*
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number

Options and Payment*

Workshop Participant $50.00

Fee will increase to $60 on January 17, 2025. No refunds can be given after January 20, 2025.

Please select this box if you would like to include a jump rope.$5.00

Jump rope cost is based on type of rope selected.

Jump Rope type (pricing varies)

A couple times a year we send emails about our team events -- tryouts, workshops, competitions. Are you interested in joining our mailing list?
Opt in on event mailings:

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Medical Release and Indemnity Agreement

I hereby request that you accept this application for registration in the Comet Skippers 2025 Winter Workshop of my child named above, and in consideration of your acceptance of this application, I hereby release Comet Skippers Inc., Mason City Schools, and all of its facilities and employees and all persons associated with the Comet Skippers Winter Workshop, of and from all claims or causes of injury to the participant arising from participation in the event, whether such injury is a result of negligence or some other cause. If medical attention is required for injury or illness while at the Comet Skippers Winter Workshop, I give permission for such medical care and will be financially responsible. I also give permission for photography and or video to be taken and used in the future for possible promotion of jump rope. **Not a Mason City Schools Sponsored Event**
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
I Agree
Signature:*
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