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.
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
