Living Skies SynchroSkate Invitational

Team Information

Team Name * :
Team Skate Canada # * :	(10 digit)
Team Event * :
Team Practice Ice Time * :
Name of Music / Theme of Performance * :

Club Information

Club Name * :
Club Skate Canada # * :	(10 digit)
Club Address * :
Club City / Town * :
Club Province * :
Club Postal Code * :
Club Contact First Name * :
Club Contact Last Name * :
Club Contact Position * :

Coach Information

Coach First Name * :
Coach Last Name * :
Coach Certification * :
Coach Certification Year * :
Coach Skate Canada # * :	(10 digit)
Coach Email * :
Coach Contact Number while in Regina * :	() -

Second Coach Information

Enable second coach

Coach First Name * :
Coach Last Name * :
Coach Certification * :
Coach Certification Year * :
Coach Skate Canada # * :	(10 digit)
Coach Email * :
Coach Contact Number while in Regina * :	() -

Team Manager Information

Manager First Name * :
Manager Last Name * :
Manager Skate Canada # * :	(10 digit)
Manager Email * :
Manager Phone # * :	() -
Manager Cell # :	() -

Team Chaperone Information

We have a Team Chaperone

Chaperone First Name * :
Chaperone Last Name * :
Chaperone Skate Canada # * :	(10 digit)

Skaters

Skater First Name * :
Skater Last Name * :
Skater Skate Canada # * :	(10 digit)
Skater DOB * :
Skater Age (as of July 1, 2018) * :

Name	Skate Canada #	DOB	Age	Action
Name	Skate Canada #	DOB	Age	Action

Send Receipt

Your E-Mail Address * :

Fees

Total :	$ 0
Team Fees :	$ 0
Skater Fees :	$ 0
Practice Fees :	$ 0

Waiver

Skate Canada EM B1.11 applies. All competitors, coaches and guests waive all claims as to accidents, loss of personal property, etc. against the Regina Synchronized Skating Teams, Skate Regina, Evraz Place, the City of Regina and Skate Canada during the course of this competition.

I/we have carefully read and understand this waiver on the 19^th day of January, 2019.