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NORTHBROOK COMPETITIVE FIGURE SKATING TEANORTHBROOK COMPETITIVE FIGURE SKATING TEAM

REGISTRATION FORM 2008 - 2009

Please check: Early Member $ 285 _____ (By June 30, 2008)
Regular Member $ 310 _____ Associate Member* $ 75 ____
* (for tot skaters younger than 5 yrs. of age as of 9/01/08;
also for FS5 and up skaters who would like to maintain
membership, but do not want to skate Friday nights;
Team Captains excluded from Associate membership)
Please list information, as you would like it to appear in the directory
Skater's Name: _______________________________________________________
Skater's Address: _____________________________________________________
Home Phone: ________________________________________________________
Parents' Names: Mother: _____________________Father:____________________
Non-Directory Information
Skater's Date of Birth: _______________________ ISI # ______________________
Skater's Coach(es): ____________________________________________________
Skater's Current Class Level _____________________________________________
Skater's Grade as of 9/01/08 _____________________________________________
Parent's Information
Family E-mail: _________________________________________________________
Mother ‘s Cell Phone: _________________________________(In case of emergency)
Father’s Cell Phone:___________________________________(In case of emergency)
Emergency Contact Name:_____________________Phone:_____________________

The undersigned agrees that at no time will the Northbrook Competitive Figure Skating Team or the Northbrook Park District be held liable for any accident or personal injury to the Team Member him/herself, or any member of his/her family.
Skater's Signature: ____________________________________ Date: _____________
Parent's Signature: ____________________________________ Date: _____________

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American with Disabilities Act Notice
The Northbrook Competitive Figure Skating Team=s activities and services are subject to
the AMERICANS WITH DISABILITIES ACT (ADA) as well as to all applicable laws regarding
non-discrimination. If you or someone you know has a disability and is interested in
attending or participating in NCFS Team activities or services, the NCFS Team will make
reasonable accommodations to facilitate that opportunity, for special needs, please check
here: ______

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