BSC 2018 Junior Camp Registration Form

2020 Buffalo Junior Summer Training Camp August 17 - 22, 2020

For Competitive Junior Skaters Ages 12 to 21
Take Your Skating & Training To The Next Level!

Join us for an intensive 6 day clinic coached by Eastern Regional Camps Director Tom Miller. Coach Miller brings his technique driven training program to Western New York for our annual camp.

The camp is designed for competitive Junior skaters, ages 12 to 21. It incorporates, Ice, Dryland and analyses. Additional training will be provided in the art/sciences of sharpening and blade setup, race preparation and injury prevention.

Sponsored by: The Buffalo Speed Skating Club.

Instructed by: Eastern Regional Camps Director Tom Miller, Additional coaching and supervision will be provided by members of the Buffalo Speedskating Club, and guest coaches.

Location: The Northtown Center at Amherst - 1615 Amherst Manor Drive Amherst, NY 14221

Dates: Monday, August 17 - Saturday August 22.

Total Ice Time: 16.5 hours (on an Olympic size rink). Total Dryland Training: 11 hours.

Registration: The camp will be limited to the first 20 applicants. The single skater fee is $450 USD. The Family discount fee is $400 USD per skater after the first skater in the same family.

Host Families: Due to the current Covid situation hosting is no longer avialable.

After you register: An information/confirmation packet will be emailed to you detailing what you should bring along with additional information about the camp and Western New York.

Athlete Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Club Name*
USS/Speed Skate Canada number:*
400 M time500 M time
Time*
I would like to stay with a host family: if yes, you will be taken to the Host Family Request Form

Yes
Performance T-Shirt size*

Host Family Request

Please Note: You will be contacted with your host family’s information approximately one week prior to the camp. It will be your responsibility to contact your host family to discuss your participants stay.
Home Life Preferences:
Allergic to Pets?*

YesNo
If yes, what types?
Please list any food allergies and or aversions:
Please list any medical conditions/concerns, and any medications that you will bring along:
Do you request to stay with a particular host family or with another camp participant? Please note that we will do our best to fulfill your request, but it can not be guaranteed.*

YesNo
Host Family:
Skater you would like to stay with:
Other requests/information you would like to share with us:

Parent/Guardian Information (If applicable)
Name

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
Address (if different from the skater's)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Add one or two additional skaters in the same family

Yes

Additional Athlete's Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*

MaleFemale
Club Name*
400 M time500 M time
Time*
Performance T-Shirt size*
Host Family Request If Applicable
Home Life Preferences:
Allergic to Pets?

YesNo
If yes, what types?
Please list any food allergies and or aversions:
Please list any medical conditions/concerns, and any medications that you will bring along:
Do you request to stay with a particular host family or with another camp participant? Please note that we will do our best to fulfill your request, but it can not be guaranteed.

YesNo
Host Family:
Skater you would like to stay with:
Other requests/information you would like to share with us:
Add a second skater in the same family

Yes

Second Additional Athlete's Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*

MaleFemale
Club Name*
400 M time500 M time
Time*
Performance T-Shirt size*
Host Family Request If Applicable
Home Life Preferences:
Allergic to Pets?

YesNo
If yes, what types?
Please list any food allergies and or aversions:
Please list any medical conditions/concerns, and any medications that you will bring along:
Do you request to stay with a particular host family or with another camp participant? Please note that we will do our best to fulfill your request, but it can not be guaranteed.

YesNo
Host Family:
Skater you would like to stay with:
Other requests/information you would like to share with us:

Confirmation

BY AGREEING ABOVE 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
Contact email:

Confirmation Email
After registering you will receive an emailed confirmation packet. Included in it will be a Skating Goal form an Authorization For Minor’s Medical Treatment form if applicable and a COVID wavier form.
Select an option:*
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New skater registration (single or first skater)$450.00

New skater registration (additional family member) $400.00

Quantity

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