Junior Blades Membership Application Form

Instructions: Click the "Print / Save as PDF" button above. In the print dialog, select "Save as PDF" as your printer destination.

IMPORTANT: Please complete all sections of this form. A copy of the parent's ID/Passport as well as the skater's ID/Birth Certificate/Passport are required when submitting this application.

Parent/Guardian Information

First Name:

Last Name:

ID/Passport Number:

Relationship to Skater:

Mobile Number:

Email Address:

Physical Address:

Skater Information

First Name:

Last Name:

Date of Birth:

Age:

Gender:

☐ Male ☐ Female

School Grade:

School Name:

Emergency Contact Information

Contact Name:

Relationship:

Primary Phone:

Alternative Phone:

Medical Information

Medical Aid Name:

Medical Aid Number:

Medical Conditions (if any):

Allergies (if any):

Current Medications (if any):

Additional Information

How did you hear about Junior Blades?

Previous Skating Experience (if any):

Interested in:

☐ Learn to Skate ☐ Figure Skating ☐ Synchronized Skating

CLUB SESSIONS:

• Saturday mornings: 08:30 - 10:00 (General skating)

• Saturday mornings: 07:30 - 08:30 (Synchronized skating)

• Location: Ice Station, GrandWest Casino, Cape Town

FEES STRUCTURE:

• Registration fee (once-off): R50

• Annual membership: R130

• Monthly subscription: R170 (Club lessons)

• Monthly subscription: R150 (Synchro)

• Rink charges: R35 per session (paid at rink)

Parent/Guardian Signature:

Date: _____________________

For Office Use Only: