SUPERIOR CURLING CLUB

2012-2013 Junior Curling Registration Form

CHILD’S NAME		ADDRESS		CHILD’S EMAIL ADDRESS
BIRTH DATE	AGE	GRADE	GENDER	YEARS OF CURLING EXPERIENCE
PLEASE LIST FOOD ALLERGIES OR ANY CONDITIONS WE SHOULD BE AWARE OF. (USE THE BACK OF SHEET IF NECESSARY)
PARENT’S NAME		PHONE NUMBER (specify WORK, CELL, or HOME)		PARENT’S EMAIL ADDRESS
		ALT PHONE (specify WORK, CELL, or HOME)
PARENT’S NAME		PHONE NUMBER (specify WORK, CELL, or HOME)		PARENT’S EMAIL ADDRESS
		ALT PHONE (specify WORK, CELL, or HOME)
ALTERNATE/EMERGENCY CONTACT		PHONE NUMBER (specify WORK, CELL, or HOME)		RELATIONSHIP TO JUNIOR CURLER
		ALT PHONE (specify WORK, CELL, or HOME)

Instructor led training will be held on Thursdays from 4 p.m. to 5:30 p.m. (Students should be dressed and ready to go at 4:00 p.m., Parents must pick up their child at 5:30 as there is no one to supervise them after that time. )

The cost of Junior Curling instruction for the 2011-2012 curling season is still $75.00 per child (21 & under)

Payment due in full by December 1, 2011, unless you work out other arrangements.

There will be a $15.00 per month late fee if not paid by in full by December 1^st, 2011.

Please make checks payable to Superior Curling Club or SCC

Additional Ice/Practice Time: There is ice-time available at other days/times for your child to practice at no additional cost, however these are non-instructor led and there may or may not be another adult in the club – during these times you or another adult you designate must be present with your child while they are in the club. (If your child is interested in additional practice time please talk To Doug Runnoe and he will let you know the best days and times and will make sure you have access to the clubhouse.)

Help is needed in order to make the Junior Curling Program work and to keep our costs down. I will welcome any adult help on the ice, or you could help by checking in kids on Thursdays, bringing and/or preparing hot chocolate and treats, and helping with the Lee Bergquist Memorial Jr. Bonspiel on Saturday, March 17^th (our club’s end-of-the-year, Spring Junior Curling Tournament).

Talk to Doug Runnoe for more information.

Would you be interested in helping as an on-ice instructor/helper? □Yes □No

Would you be interested in helping check students in before lessons? □Yes □No

Would you be interested in bringing in/helping serve treats and hot chocolate? □Yes □No

Would you be interested in helping with the Lee Bergquist Memorial Jr. Bonspiel? □Yes □No

SUPERIOR CURLING CLUB TO COMPLETE THE BELOW INFORMATION

DATE REGISTRATION FORM COMPLETED

DATE RELEASE FORM COMPLETED

DATE DUES PAID