Clone of Vegreville Skating Club 2025-26 Registration Form

Student Name

First NameLast Name

Gender

Birth Date

DayMonthYear

Medical conditions or special needs

Address

Street Address

Street Address Line 2

CityProvince

Postal Code

Parent/Guardian 1 Name

First NameLast Name

Parent/Guardian 1 Mobile

Area CodePhone Number

Parent/Guardian 1 Email

example@example.com

Parent/Guardian 1 Home

Area CodePhone Number

Parent/Guardian 2 Name

First NameLast Name

Parent/Guardian 2 Mobile

Area CodePhone Number

Parent/Guardian 2 Email

example@example.com

Parent/Guardian 2 Home

Area CodePhone Number

Emergency Contact

First NameLast Name

Emergency Contact Ph.

Area CodePhone Number

Outline of Programs

Choose a Program

Skate Canada Insurance Amount

Vegreville Skating Club Mandatory Fundraising Fee

Each family is required to purchase a ticket booklet for $100 (containing 5 tickets at $20 each). The family can then choose to keep the tickets or sell them. Additional information will be provided at a later date.

Total Cost

Autopopulated

PAYMENT DEADLINES (1ST DAY OF SKATING)

Payment Option - NOTE that Full Insurance Cost is due IMMEDIATELY upon receipt of registration and must be PAID IN FULL prior to the start of skating or your skater will not be allowed on the ice.(NOTE IF APPLYING FOR ANY SUBSIDIES PLEASE CHOOSE OPTION 1)

OPTION 2: TWO INSTALLMENTS - #1

1st Installment + Full Insurance

OPTION 2: TWO INSTALLMENTS - #2

2nd Installment

OPTION 1: FULL PAYMENT

Full Payment

NOTE:

Please do not submit payment until you receive an invoice from the club. Thanks!

Anticipated Costume Size (for Carnival) - March 2027. Please anticipate for growth, jackets etc.

CLUB RULES: Please acknowledge by checking each box - REQUIRED

SKATE CANADA ASSUMPTION OF RISK AND WAIVER- *REQUIRED*

PLEASE READ CAREFULLY:

1. ACKNOWLEDGMENT OF INHERENT RISK I understand that participation in skating, figure skating, and any other sporting activities listed in the enclosed appendix (hereinafter the “Sports Activity”) is voluntary, and involves inherent risk during participation, including the risk of possible accidents, physical injury, or exposure to the COVID-19 virus or other infections or infectious diseases as a result of attending training, club events or competitive events. I freely accept and fully assume all such risks, dangers and hazards, including but not limited to personal injury, disease transmission, death, property damage or loss, resulting from my participation. I have carefully considered the risks involved, and I have full confidence that reasonable precautions will be taken to ensure the safety and well-being of myself (or my son/daughter/ward).2. WAIVER I do for myself (or my child), and our respective heirs, executors, administrators, successors and assigns, hereby waive, release, and forever discharge Skate Canada and/or Skate Canada: Alberta-Northwest Territories/Nunavut Association (Skate Canada: Alberta-NWT/Nunavut Section), all Regions of Skate Canada: Alberta-NWT/Nunavut Section, Vegreville Skating Club, their officers, partners, agents, employees, servants, representatives, volunteers, coaches, officials, successors and assigns (the “Representatives”) of and from any actions, causes of action, complaints, demands and claims or any recourse whatsoever (“Claims”) that I have or may have in the future in any way connected with my (or my child’s) participation in the Sports Activity contemplated herein, whether in law or in equity, in respect of personal injury, illness or disease transmission, loss of life, or property damage of any kind or nature, and I do hereby discharge the Representatives from any such liability. This includes negligence, breach of contract or breach of any statutory or other duty of care.3. INDEMNIFICATION I further agree to fully indemnify and defend Skate Canada and/or Skate Canada: Alberta-NWT/Nunavut Section, all Regions of Skate Canada: Alberta-NWT/Nunavut Section, Vegreville Skating Club and any of their Representatives from and against any and all Claims brought against Skate Canada and/or Skate Canada: Alberta-NWT/Nunavut Section, all Regions of Skate Canada: Alberta-NWT/Nunavut Section, Vegreville Skating Club and any of their Representatives, including all related costs and expenses, and against any loss, costs, damages, or expenses which Skate Canada and/or Skate Canada: Alberta-NWT/Nunavut Section, all Regions of Skate Canada: Alberta-NWT/Nunavut Section, Vegreville Skating Club and any of their Representatives may sustain, suffer, incur, or be liable for resulting from, arising from, or in any way related to my (or my son/daughter/ward’s) participation in the Sports Activity. I also agree and undertake not to make any claim or take any proceedings against the Representatives set out above, or any other person or corporation which might claim contribution or indemnity under the provisions of any statute or otherwise from the Representatives set out above.Parent/Guardian I certify that I am the parent or legal guardian of the participant named below and that I am entitled to his or her custody and control. I understand the aforesaid inherent risks that could arise from these activities, I grant permission for my son/daughter/ward to participate in the Sports Activity and other activities incidentally thereto and I execute this Assumption of Risk and Waiver on behalf of myself and my son/daughter/ward.

CLUB RULES - REQUIRED
I, First Name* Last Name* , have read and understand the Club Rules and the Skate Canada Assumption of Risk and Waiver (checked off above).

Vegreville Skating Club

Parent/Guardian Information

Program (see website for further program details)

PAYMENT CALCULATOR