Ice Oasis

(One Skater per form, forms may be duplicated)     New Student to Ice Oasis?   Yes   No   (circle one)

Are you a member of the Ice Oasis Skating & Hockey Club?    YES    NO     (If YES, please fill this out only if you wish to change your contract class(es)).

Student Name: ____________________________________ Date of Birth: _____________Age:_____

Parent’s Name: ____________________________________ E-Mail:___________________________

Address: ________________________________________ City: _______________________ Zip Code:______________

Home Phone:_______________________ Work Phone:_______________________ Emergency/Cell Phone:_______________________

I, the undersigned, do hereby voluntarily submit my application to enroll in the Ice Oasis Skating School. I agree to follow all Ice Oasis Rink rules designed to reduce the risk of injury, but will not prevent all injuries while skating. There is no guarantee for my/my child's safety. I understand that there are risks involved with ice skating and that injuries are common and can be serious, even if I/my child skate(s) in control and wear(s) protective gear. I freely assume these risks and release Ice Osis, Inc., employees, and coaches from any liability, claim, or suit out on my/my child's participation in ice skating. I/my child skate(s) at my/my child's own risk. Failure to comply with the Rules of Ice Oasis may result in my removal from the Ice Rink with no refund. I fully understand that the Ice Oasis may change the instructional time, or cancel a class due to insufficient enrollment. I fully understand that the Ice Oasis is not required to refund to me any portion of my registration or program fee unless the program paid for is cancelled in which case the unused portion of the program will be refunded. Any class cancelled by student is subject to a $25.00 processing fee, unless cancellation notice is received by Ice Oasis Skating Director prior to first class meeting. I fully understand that if I or my child cannot attend a regular lesson scheduled by the school, a make-up lesson may be provided; but the Ice Oasis is under no obligation to provide for such make-ups. Missed classes may only be made up prior to the lat day of the skating school series in which I or my child is enrolled.....................................  I HAVE READ AND UNDERSTAND THE FOREGOING RELEASE.

Participant's Signature (or Parent/Guardian) ____________________________________________ Date: ______

Skating Class #1: ________________________________Day:______________Time:___________Cost:__________

Skating Class #2:_________________________________Day:______________Time:___________Cost:__________

Skating Class #3:_________________________________Day:______________Time:___________Cost:__________

Annuall ISI Membership (required) $ 13.00

Add $10 late fee for enrollment on or after 1st day of class: __________

Total Due: __________

Note: A service charge of $25 is due for returned checks

Account #: ____________________________________________Expiration date: __________Name on card: __________________________

I give the Ice Oasis permission to charge the above fees on this charge card:  Signature_____________________________________________________

Susan Blaisdell, Director, Skating School : 650 364 8090 Ext 16 ***  Fax 650 364 8634