CORNERSTONE SPEED SKATING REGISTRATION FORM

2009/2010 SEASON

SKATER #1 NAME:____________________________

SKATER #2 NAME:____________________________ 

SKATER #3 NAME:____________________________

PARENT'S NAMES:____________________________

ADDRESS:___________________________________

PHONE NO.:__________________________________

EMAIL ADDRESS:_____________________________

Cell phone # (optional):  ________________________

REGISTERING FOR: 

Please check off all programs that you are registering for.

¡SUNDAY NIGHTS FAMILY SPEEDSKATING PROGRAM – 6:15 – 7:35 p.m.                               

Full Season   $245.00 (20 weeks) X______ skaters =_________                                             

1^st Session     $135.00 (10 weeks)    X______ skaters =_________

Please note the 1^st session fee is only available to first time club members.

Family discount:  1^st two paid registrations, 3^rd and smallest member is free.

¡THURSDAY NIGHT PRACTICES – 7:15 - 8:20 p.m.

Full Season     $245.00 (21 weeks)  X______ skaters =_________                      

Family discount:  1^st two paid registrations, 3^rd member is free.

¡FRIDAY NIGHTS TEAM SPEEDSKATING PROGRAM - 5:30 – 6:50 p.m.                               

Full Season         $245.00 (20 weeks)  X______ skaters =_________                      

Family discount:  1^st two paid registrations, 3^rd member is free.

SKATE RENTAL - $60 per pair for the season…please read and fill out the attached skate rental contract…conditions apply

CORNERSTONE SPEEDSKATING PROGRAM

SKATE LEASE/RENTAL AGREEMENT 2009/2010

We, the Cornerstone Community Ice Center, herein after, CCC, hereby

leases/rents to _________________________&_____________________________

 (Parent/Guardian if under 18)                           (Skater) 

herein after termed skater, and Parent/Guardian, a pair of speed skating boots and blades, including laces, mounts and hardware, for the 2009/2010 season, ending March 28th, 2010, at a lease/rental fee of $60.00.   Skates must be returned sharp and in similar condition to that they were received in at the end of the season. 

1)      The skater and Parent/Guardian named __________________ & _______________ agree to pay the lease/rent to the terms and conditions set forth herein.

2)      CCC is leasing/renting one pair of skates, size ______, skate #_______ with blade mounts, and laces to the above named skater.  Skates are to be kept in the cabinet in the speed skating room at CCC, unless signed out for a meet or event, in which case they are to be returned at the practice immediately following the event/meet.

3)      The above named skater and parent/guardian is at all times responsible for the maintenance and excellent care of the above referenced skates.  Skaters and parents are responsible for taking care of the blades, wiping them dry after each ice session, replacing the soft fabric blade covers and placing them in the speed skating cabinet in the appropriate designated place after each ice time.  Skaters will use hard guards to protect the blade when walking on them to the ice surface.

4)      Sharpening of the skates is not included in the price of the rental, and must be done on appropriate speed skating sharpening equipment only, and by a knowledgeable club member or trained sharpener.

5)      CCC, and any of the coaches, volunteers, or officials, will not be held responsible and are held harmless for any injuries that result from the use of the above mentioned boots and blades, also known as "skates".  The leasing/renting party agrees and acknowledges that speed skating is a dangerous sport that may result in serious and/or permanent injury or death.

6)      Should the boots and blades not be returned within 30 days of signing the skates out of the facility for a meet/event, CCC reserves the right to seek monetary compensation in the amount of the value of the skates.

7)      The value of the referenced boots and blades, including laces, mounts and hardware, also known as "skates", is $300, which if monetary compensation is sought, is due and payable in full within 30 days from the last day of the scheduled season, unless arrangements have been made with a club officer to extend the rental period.

Skater's signature _____________________________________________

Parent/Guardian signature_______________________________________

Date:_______________________________

Address:___________________________ City:_________________ State:______

Zip:______________ Phone #:____________________  Email:__________________________

CCC Representative's signature:_____________________________           

CORNERSTONE SKATING CLUB

SPEED SKATING PROGRAM

RELEASE FORM

2009/2010 SEASON

In consideration of acceptance of this application in the above program, I hereby waive, release and discharge any and all claims for damages I may have against Team Cornerstone Speed Skating, Wisconsin Speed Skating Association, U.S. Speed Skating, Cornerstone Community Ice Center, or their assigned personnel involved in the program, or officers and members for any and all liability arising out of or connected in any way with my participation in said program, even though liability arises out of negligence on the part of the persons or entities mentioned above, or for any claim for lost or stolen personal property of any description.  It is further understood and agreed that this waiver, release and assumptions of risk is to be binding on my heirs and assigns.  Further, the undersigned agrees to the Code of Conduct of U. S. Speed Skating, and will properly wear all required safety equipment.

____________________           ________________________

Applicant's signature   AND   Parent or guardian (if under 18)      

Date ___________________________________________

CONSENT FOR MEDICAL TREATMENT (If Under 18)

I, the parent of _____________________________, (child's name), if I cannot be contacted through reasonable efforts, hereby give permission to the officers or personnel of Cornerstone Speed Skating and/or Cornerstone Community Ice Center, to call or drive my child to the physician, dentist, or hospital if a need for emergency treatment exists.  An ambulance may be called if necessary.  I do hereby authorize the treatment by a licensed medical physician, of my child in the event of a medical emergency, which in the opinion of the attending physician, may endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed.

___________________________________________________

(Parent signature)                (Date Signed)

CODE OF ETHICS AGREEMENT

I agree to abide by the rules of the Cornerstone Speed Skating and the Cornerstone Community Ice Center.  I will be respectful and supportive of all other speed skating program participants, parents and staff and all other sport programs held in this facility.   I will strive to give positive feedback only and to be respectful of other's feelings.  

__________________________    _______________________              

Applicant's signature  AND   Parent or guardian (if under 18)

Date_____________________________________________