PENINSULA SPEED SKATING CLUB REGISTRATION

Location:
Panorama Recreation
1885 Forest Park Dr.
North Saanich, BC
V8L 4A3

Ice Times:
Mondays @ 5:45 – 6:45 PM

Fees:
One Skater $190.00
Two Skaters $330.00
Three Skaters $445.00

Buddy Club Registration with Esquimalt Speed Skating $100.00 per skater (allows access to the 3 weekly ice times at Esquimalt as well).

Name:_________________________

Address:_________________________

Postal Code:__________ Phone:__________

Email:_________________________

Birthdate:_________________________

Age on July 1, 2006:_________________________

Gender:_____ BC Skating#:_______________

In consideration of my accepting this registration, I hereby, for myself, my heirs, executors, administrators and assigns waive and release any and all rights and claims for damages I may have against the Peninsula Speed Skating Club, its agents officers or members, for any and all injuries suffered by me during the 2006-2007 season.

Date:_________________________

Signature:_________________________
parent or guardian if under 18 yrs of age

Skate Rental:__________ Size:__________