Kentwood Ice Arena Skater Registration Form
Player Information-Please Print-Full Legal Name
 
Your completed registration and non-refundable deposit guarantees your child a space in the program(s) selected below. Any program filled prior to receipt of your registration form you will be notified and placed on a waiting list if desired. No registration will be accepted without proper deposit and completed registration form.
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Birth Date______________________ School/District_______________________________
 
Legal Name___________________________________________________________________
 
Address____________________________________________________,MI________________
                Street                                                                                   City                                               Zip
 
 
 
Primary Parent Contact____________________________________________________
 
Phone #_________________________Email___________________________________
 
Secondary Parent Contact__________________________________________________
 
Phone # ________________________ Email___________________________________
 
Today's Date____________Payment  Amount $__________Cash  ( )   Check ( ) ________
 
Credit Card  #____________________________________________Exp. date_________
 
Signature________________________________________________________________
Please Check one of the following
Learn To Skate  ______ $79  Session 1      _____$79   Session 2    _____$79.00 Session 3
 
Learn To Play Hockey   ______$99 Session 1     ______$99 Session 2  ______$99  Session 3
 
All 3 Sessions - 10% discount    ______ LTS $213.30    _______LTPH  $267.30
All 3 session discounted amounts must be paid by the second ice time of session 1
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FALL
SCHEDULE
for
LTS & LTPH
 
Session 1
Sept. 20- Nov. 8
 
Session 2
Nov. 22-Jan. 10
 
Session 3
Jan. 17-Mar14