Wilmington FSC Learn to Skate Program 2009-2010:  File Copy – Please print clearly          

Skaters name: ________________________________________DOB: _________________M _____F______
Parents Name:  ____________________________________________________Tele # __________________
Address: ___________________________________________Town: _______________Zip ______________

**PLEASE ENTER AN EMAIL ADDRESS, We will send updates and information throughout the year!
(We will not sell or distribute your address to anyone.)

**E-mail address
____________________________________________________________________________

Highest level of skating achieved (please circle the badge level your child is IN)

My child has never skated in a skating program______________  child’s age_______________    

Snowplow Sam/Tots:  1, 2, 3 (Ages 3-5)             Where Skated _________________
Learn-to-Skate Hockey:                                      Where Skated_________________                         
Badge: 1  2  3  4  5  6  7   8                                Where Skated _________________                    
Freestyle: 1  2  3  4  5  6                                     Where Skated _________________

Please send the completed form to: Wilmington Figure Skating Club, PO Box 219, Wilmington MA. 01887.
Attention Badge Coordinator.  Deposit fee of $25.00 due with registration form.  Balance due by the first night.

It is the policy of the WFSC not to refund any monies except in those cases where serious injury and/or illness
render that skater unable to participate for an extended period of time.  These conditions should be brought to the
attention of the Board of Directors as soon as possible and be supported by a medical note/evaluation.  
Injuries/illnesses, which result in a limited absence, will not be considered.  One makeup class is allowed per session
and must be used during the session in which it was missed.  Single blade skates are required.  Helmets are
required for all skaters ages 3-6 and for anyone who has never skated.
                                          

Parent/Guardian (please sign)________________________________________________________________

                                     July 10-August 28   -   Fridays  -  6:00-6:50pm

Summer Session
     July 9 - August 28   (8 weeks)                                                             $    91.00
     USFS Registration/Membership Fee (7/1/2009-6/30/2010)                  $  10.00
      Amount Due:                                                                                         $101.00

Please note a savings of $13.00 for the summer session.  8 weeks of skating for the price of 7!!!!

All classes are held at the Ristuccia Memorial Arena, 190 Main Street, Wilmington
For further information, please call 978-694-9650.

Please Make Check payable to WFSC:
Summer:      Deposit/date ________Check # ________Balance ________Check # ________ PIF _______