Professional Staff Information Karen Healey (315) 265-1024 Intermediate Freestyle, Pre Silver Dances
$100 DEPOSIT DUE FOR EACH APPLICATION FOR SESSIONS 1 & 2
FULL PAYMENT DUE: July 1st, 2015
Alicia Walter (315) 328-4008,
[email protected] Gold Medalist, PSA Senior Rated
Danielle Bartow (315) 268-1428 Quadruple Gold Medalist, PSA Member
GUEST COACHES Tara Bartlett Michael Bartow Lisa Cardinal Tomas Morbacher
*ALL GUEST SKATERS MUST PAY FEE BEFORE EACH SESSION AND BEFORE STEPPING ON ICE* SEND APPLICATION TO:
2015 Summer Figure Skating School CHEEL ARENA July 20th — August 14th USFS TEST 8/15
Clarkson University Cheel Arena Box 8734, 8 Clarkson Ave. Potsdam, NY 13699 ATTN: 2015 Figure Skating School INSURANCE: Each student must be covered by family or other accident insurance and also by family or other health insurance. Insurance covering personal possessions is not provided. Parents or Guardians are to consult with an insurance advisor to ensure that students have adequate coverage for accidents, illness and personal possessions. EQUAL OPPORTUNITY POLICY: Clarkson University does not discriminate on the basis of race, gender, color, creed, religion, national origin, age, disability, sexual orientation, veteran or martial status in provision of educational opportunity or employment opportunities and benefits
Clarkson University Cheel Arena Box 8734, 8 Clarkson Ave. Potsdam, NY 13699 ATTN: 2015 Figure Skating School (315) 268-4327 www.clarksonathletics.com
4– WEEK SESSION SPECIAL PRICE
Tentative Summer Ice Schedule
CLARKSON SUMMER FIGURE SKATING APPLICATION
Instructions are additional. Limited space available for these sessions:
Name:____________________________________________________________ Age:________ Birthdate:____/____/_______ Gender:___________Parent(s)/Guardian(s) Name:______________________________________________________________
Session I: Monday—Friday
Address:______________________________________________________Email:_____________________________________
Ice time only, make your own arrangements for private lessons 2:45—4:15
Phone #: Home___________________________ Cell:___________________________ Work____________________________ Tests Passed:
Session II: Monday—Friday Ice time only, make your own arrangements for private lessons 4:30—6:00
Badge School I: July 20th—August 12th Mondays and Wednesdays: 6:15—7:15 Beginner skaters thru Freestyle 6
Freestyle:_______
Adult School I: July 20th—August 12th Mondays and Wednesdays: 7:15—8:15 Includes one 15 minute lesson and one hour of ice time. Can also make arrangements for private lessons.
SATURDAY, AUGUST 15th
Chairman/Club Officer signature:________________________________________________________________
ADULT SCHOOL: Daily Skating:
(Monday or Wednesday) $15/day
# of Days: ________ x $15=________
(Monday & Wednesday) $25 for both days
# of Weeks:________ x $25=________
(Monday or Wednesday) $15/day
# of Days: ________ x $15=________
(Monday & Wednesday) $25 for both days
# of Weeks:________ x $25=________
BADGE SCHOOL: Daily Skating:
Current Badge Level:___________________
Weeks Requested: (Select from these weeks for Badge and Adult Schools above, and week-long classes below) August 3rd—August 7th _____
Session I: 1-4 weeks Session II:
Full 4-week session package only
1-4 weeks
Application received by July 1st and paid in full, will receive a $25 discount per 4-week package ($335 total)
July 27th—July 31st _____
August 10th—August 14th ____
*Skaters work on USFS test*
**Early Registration Special** (Not for Adult/Badge Schools)
USFS#:_________________________
Home Club Permission: Your home club test chairman/club officer must sign below to certify that you are eligible in accordance with the USFS to participate in a USFS test session. It must be signed before submitting this application.
July 20th—July 24th _____
TENTATIVE TEST DATE:
Dance:_______
*All skaters must be registered with the USFS by July 1st*
Includes one 15 minute lesson and one hour of ice time. Can also make arrangements for private lessons.
Moves:_______
# of Weeks:____ x $90 = ________
*Please submit completed Health Form with Application*
# of Weeks:____ x $90 = ________
For an Electronic version of this Application, visit: www.clarksonathletics.com, under the “Fitness CTR/REC” tab, click on “Camps & Clinics”
Make payment to “Clarkson University.” Deposit is $100 of the total with each individual. Non-refundable processing fee (Not additional): $25
Please Note: Four week package skaters will have priority in scheduling. Guest skating is on a space available basis only and For more information on ice times, contact: Karen Healey: (315) 265-1024 For any other questions, contact: Jamey Hoose: (315) 268-4327
will coast $25/session. This fee must be paid BEFORE stepping onto the ice before each session. I have read and agree to abide by the Guiding Principles (And parent/guardian if skater is under 18 years of age) Skater’s Signature:__________________________________________________________ Date:____________________ Parent/Guardian Signature:___________________________________________________ Date:____________________