Kansas City FSC / Silver Blades FSC
2011-2012 Club Ice Contract

Please refer to the full Ice Contract found on the KCFSC web site for full details regarding KCFSC/SBFSC Club Ice.

Skater Information

* Skater #1 First Name:

* Skater #1 Last Name:

* USFS #:

* Skater #1 Home Club:

* Skater #1 Primary Coach:

* Please indicate the sessions that Skater #1 is signing up for:

Skater #2 First Name:

Skater #2 Last Name:

USFS #:

Skater #2 Home Club:

Skater #2 Primary Coach:

* Please indicate the sessions that Skater #2 is signing up for:

* Please select the payment plan

Lump Sum Payment

4 Quarterly Payments

10 Monthly Payments (only available if purchasing 4 or more sessions)

* Please indicate the total number of sessions you are purchasing on the lump sum payment plan (enter 0 for any sessions you do NOT want):

	Monday - 5:25pm - 6:25pm (FS)
	Monday - 6:25pm - 7:25pm (FS)
	Friday - 4:45pm - 5:45pm (FS)
	Saturday - 8:50am - 9:50am (FS)
	Saturday - 10:00am - 11:00am (FS)
	Saturday - 11:00am - 11:15am (Power & Edge)

* Please indicate the total number of sessions you are purchasing on the quarterly payment plan (enter 0 for any sessions you do NOT want):

	Monday - 5:25pm - 6:25pm (FS)
	Monday - 6:25pm - 7:25pm (FS)
	Friday - 4:45pm - 5:45pm (FS)
	Saturday - 8:50am - 9:50am (FS)
	Saturday - 10:00am - 11:00am (FS)
	Saturday - 11:00am - 11:15am (Power & Edge)

* Please indicate the total number of sessions you are purchasing on the 10-month payment plan (enter 0 for any sessions you do NOT want):

	Monday - 5:25pm - 6:25pm (FS)
	Monday - 6:25pm - 7:25pm (FS)
	Friday - 4:45pm - 5:45pm (FS)
	Saturday - 8:50am - 9:50am (FS)
	Saturday - 10:00am - 11:00am (FS)
	Saturday - 11:00am - 11:15am (Power & Edge)

Billing Information

* 1st Parent Name:

2nd Parent Name:

* Address:

* City:

* State:

* Zip:

* Home Phone Number:

Cell Phone Number:

* Contact E-mail:

Legal Stuff

By selecting "All Parties Agree" below, that acts as the electronic signature for all parties in this contract.

*

All parties, skaters and parents, have read and agree to all rules and conditions detailed in the KCFSC/SBFSC Club Ice Information Sheet and Contract.

I hereby release the Kansas City Figure Skating Club, Silver Blades Figure Skating Club, along with their officers and members, from any responsibility for injuries suffered during club ice. I agree to abide by the clubs' regulations, ice rules, music procedures and to pay ice fees in a timely fashion according to the contract terms and conditions.

All parties agree.

* Indicates Response Required