Address: _________________________________________________________
Telephone: _________________________ E-Mail: _________________________
US Figure Skating Test Level: __________________________________________
Coach: _____________________________________________________________
Emergency Contact: ___________________ Phone: _______________________
(check applicable)
Full Membership $75 o
Additional Family Membership $20 o
Non-Skating Parent Membership $15 o
Coach (Associate Membership) $50 o
Membership year is July 1 – June 30th
o Competitive Skater o Recreational Skater o Adult Skater
o Synchro Skater o Collegiate Skater o Club Officer/Board Member
o Parent o Volunteer o Coach