Fishers Figure Skating Club ’07-’08 Membership Application
__ New Member __ Renewing Member __Transferring – Previous Home Club__________ (please attach “notice of change of home club” form)
Primary Member____________________MIF Test Level__________FS Test Level___________
Birth Date___/___/___ USFSA #___________Skater? Yes No US Citizen? Yes No
Street Address___________________________________City____________________
State____Zip_____Email________________________________________________
Day phone__________________________Cell/alternate ____________________________
Additional Members MIF Test Level FS Test Level Birth Date USFSA#
2. __________________________ _____________ ____________ __/___/___ ________
3.___________________________ _____________ ____________ __/__/____ ________
4.__________________________ _____________ ____________ __/__/____ ________
Waiver and Release
I understand normal and usual ice skating activities could result in personal injury, damage or even death. Despite my knowledge of said risks, and in consideration of my and/or my child(ren)/guardian(s) being permitted to participate in Fishers Figure Skating Club (FFSC)activities, I expressly and voluntarily agree to assume such risks that I or my child(ren)/guardian(s) may suffer by participating in any FFSC sponsored lessons, practices, events, club activities, test sessions and competitions and agree to hold harmless and free from liability, injury or loss whatsoever, the Fishers Figure Skating Club, it officers, directors, members, or agents. In addition, I herby give permission for emergency medical treatment to the skater should that become necessary.
_____________________________________________________________
Primary Member or Parent/legal Guardian of Skater under 18
________________________________________________ ________________
Signature of Primary Member or Parent/legal guardian date
Membership Acceptance
By acceptance of membership, I agree to be bound by the bylaws and rules of FFSC and agree to pay all membership dues and to volunteer for the required fundraising activities as required by FFSC or as indicated on this application. I understand that all test or competition forms signed in advance can be recalled at any time if there is a financial delinquency to FFSC. I grant permission to FFSC to utilize any photograph, video recording, of me and or my child(ren)/guardian(s) taken during FFSC functions or events and allow posting of pictures on the FFSC programs, literature, and website. I agree to allow FFSC to use all pertinent contact information in the FFSC directory. I understand I can withhold the release of information or decline to give permission for FFSC to use any photographs or video recording of me and/or my child(ren), by indicating so in writing and attaching it to this form.
_____________________________________ _____________
Signature of primary member or parent/legal guardian Date
Membership Categories: Full Membership: Fee/Dues Office Use Only
Sunday Club ____________
Thursday Club ____________ Check #
Sunday and Thursday Club ____________ Received ___/___/___
Club Representation ____________ By ______
Associate ____________
Professional ____________
Booster ____________
Category Descriptions, fees and dues:
All fees/dues include USFSA membership
Full Memberships:
Sunday Club:
Member chooses to skate on Sunday Club ice only. Walk on fee for skating on Thursday ice.
Fee/Dues: $230
Thursday Club:
Member chooses to skate on Thursday Club ice only. Walk on fee for skating on Sunday ice.
Fee/Dues: $215
Sunday and Thursday Club:
Member chooses to skate both Sunday and Thursday club ice times. No walk on fee for these.
Fee/Dues: $325
(Families with more than 1 skater- fee/due cap of $500)
Associate Membership:
Full Membership with another club. (Need documentation of membership)
Requires walk on fee to skate any of the Club Ice. Walk on fee $10
Fee/Dues: $75
Club Representation:
Join FFSC as a full member
No Club Ice benefit. May skate club ice with walk on fee of $10.
Fee/Dues: $100
Professional:
This includes coaches, choreographers, etc.
Must pay professional fee to coach at FFSC.
Fee/Dues: $45 (if USFSA membership needed)
Booster:
Non-skater 18 years old or older who supports the club.
Fee/Dues: $50
Memberships include USFSA membership number, subscription to Skating Magazine, Testing and Competition privileges. FFSC activities which may include lock-in, annual King’s Island trip, Award and recognition banquet, annual ice exhibition and other social functions. Additional fees may be required depending upon the type of activity and the participants membership category.