Ice-Tech Registration Form for Winter 2018

Please complete all areas of this form, read the Waiver and sign where indicated.
Print Form

MAIL TO:
Ice-Tech
PO Box 20002
355 Hespeler Rd
Cambridge, Ontario N1R 8C8
PLEASE NOTE:
Please include payment with this form.
Cheques only by mail. Cash or cheque only in person
No credit cards or debit in person
 
Skater’s First Name ___________________________ Last Name ____________________________________

Address _____________________________ City _________________________ Postal Code ____________

Birth Date: _______________ Home Phone__________________ Business/Cell Phone __________________

Email: _________________________ Number of Years Skated ____ Parent’s Name ____________________

Medical/Behavioral Notes (if any) _____________________________________________________________
WAIVER: I acknowledge that Ice-Tech Skating Programs, and its directors or instructors will not be held
responsible or liable for any accident or loss, however caused, and agree to release Ice-Tech from all damages
or claims which may arise as a result of such accidents or loss. I hereby give permission to seek out any medical
assistance my child (or adult) may require while attending the program.
 
Date: _______________ Parent/Guardian Signature: _____________________________________________

Payment by CASH or CHEQUE ONLY – no credit cards or debit. All prices include HST.
Cheques payable to: IceTech
Please “check” a session. All sessions are 50 minutes.
Session Day Time Location Session Dates Weeks Total Cost
Parents and Tots
2 - 3 years
Sunday 10:00 - 10:50 AM Sportsworld Twin Pad Jan 7 - March 11 2018 10 $130.00
Parents and Tots
2 - 3 years
Sunday 1:40 - 2:30 PM Cambridge Ice Centre Jan 28 - March 25 2018 9 $115.00
Parents and Tots
2 - 3 years
Friday 5:40 - 6:30 PM Cambridge Ice Centre Jan 26 - March 30 2018 10 $130.00
Parents and Tots
2 - 3 years
Saturday 9:00 - 9:50 AM Lions Arena Kitchener Jan 6 - March 10 2018 9 $115.00
Parents and Tots
2 - 3 years
Saturday 10:40 - 11:30 AM Cambridge Ice Centre Jan 27 - March 31 2018 10 $130.00
Preschool
3 - 5 years
Sunday 10:00 - 10:50 AM Sportsworld Twin Pad Jan 7 - March 11 2018 10 $175.00
Preschool
3 - 5 years
Sunday 12:40 - 1:30 PM Cambridge Ice Centre Jan 28 - March 25 2018 9 $160.00
Preschool
3 - 5 years
Sunday 1:40 - 2:30 PM Cambridge Ice Centre Jan 28 - March 25 2018 9 $160.00
Preschool
3 - 5 years
Wednesday 5:40 - 6:30 PM Cambridge Ice Centre Jan 10 - March 28 2018 12 $210.00
Preschool
3 - 5 years
Wednesday 6:40 - 7:30 PM Cambridge Ice Centre Jan 10 - March 28 2018 12 $210.00
Preschool
3 - 5 years
Friday 5:40 - 6:30 PM Cambridge Ice Centre Jan 26 - March 30 2018 10 $175.00
Preschool
3 - 5 years
Saturday 9:00 - 9:50 AM Lions Arena Kitchener Jan 6 - March 10 2018 9 $160.00
Preschool
3 - 5 years
Saturday 10:40 - 11:30 AM Cambridge Ice Centre Jan 27 - March 31 2018 10 $175.00
Preschool
3 - 5 years
Saturday 11:40 AM - 12:30 PM Cambridge Ice Centre Jan 27 - March 31 2018 10 $175.00
Learn To Skate
6 years - teen
Sunday 10:00 - 10:50 AM Sportsworld Twin Pad Jan 7 - March 11 2018 10 $182.00
Learn To Skate
6 years - teen
Sunday 12:40 - 1:30 PM Cambridge Ice Centre Jan 28 - March 25 2018 9 $165.00
Learn To Skate
6 years - teen
Sunday 1:40 - 2:30 PM Cambridge Ice Centre Jan 28 - March 25 2018 9 $165.00
Learn To Skate
6 years - teen
Wednesday 5:40 - 6:30 PM Cambridge Ice Centre Jan 10 - March 28 2018 12 $220.00
Learn To Skate
6 years - teen
Wednesday 6:40 - 7:30 PM Cambridge Ice Centre Jan 10 - March 28 2018 12 $220.00
Learn To Skate
6 years - teen
Friday 5:40 - 6:30 PM Cambridge Ice Centre Jan 26 - March 30 2018 10 $182.00
Learn To Skate
6 years - teen
Saturday 9:00 - 9:50 AM Lions Arena Kitchener Jan 6 - March 10 2018 9 $165.00
Learn To Skate
6 years - teen
Saturday 10:40 - 11:30 AM Cambridge Ice Centre Jan 27 - March 31 2018 10 $182.00
Learn To Skate
6 years - teen
Saturday 11:40 AM - 12:30 PM Cambridge Ice Centre Jan 27 - March 31 2018 10 $182.00
Figure Skating
7 yrs - teen
Wednesday 6:40 - 7:30 PM Cambridge Ice Centre Jan 10 - March 28 2018 12 $235.00
Figure Skating
7 yrs - teen
Friday 5:40 - 6:30 PM Cambridge Ice Centre Jan 26 - March 30 2018 10 $195.00
Figure Skating
7 yrs - teen
Saturday 11:40 AM - 12:30 PM Cambridge Ice Centre Jan 27 - March 31 2018 10 $195.00
Adults
Saturday 10:40 - 11:30 AM Cambridge Ice Centre Jan 27 - March 31 2018 10 $205.00
Hockey Fundamentals
5 - 9 years
Saturday 8:40-9:30 AM Cambridge Ice Centre Jan 27 - March 31 2018 10 $200.00
Hockey Goalie Fundamentals
5 - 9 years
Saturday 8:40-9:30 AM Cambridge Ice Centre Jan 27 - March 31 2018 10 $250.00
 
Notes:_______________________________________________________________________________________