WINTER I 2017-18 CLASS REGISTRATION   November 5th, 2017 – January 21st, 2018 Sunday 3:50-4:35 p.m. Tuesday 6:05-6:50 p.m. Thursday 6:05-6:50 p.m. Snowplow Sam Ages 3-6 Designed for younger skaters to build confidence while learning to skate incorporating fun and game to make class time an enjoyable for all. Helmets (bike or hockey) are recommended. Basic Skills K-12 and Adult This program teaches fundamentals to all ice sports, including forward / backward skating, turns, stops, and crossovers. Skaters advance levels after testing for level elements. Pre Free Skate K-12 Learn skills needed to advance in figure skating, including jumps and spins. This class is the next step for skaters who have passed basic 6. Learn to Skate USA is endorsed by U.S. Figure Skating, USA Hockey, US Speed Skating, and the Special Olympics. See LearnToSkateUSA.com Steve Hartsell, Skating Director (248) 762-5201 Midland Figure Skating Club 405 Fast Ice Drive Midland, MI 48642 www.midlandfigureskatingclub.org email: contactus@midlandfigureskatingclub.org WINTER I 2017-18 CLASS REGISTRATION  Skater: ______________________________ M F DOB: ________________________ Age: _________ Address: ________________________________________ City: _________________________ Zip: ____________ Home Phone: _________________________ Parent/Guardian: ____________________________________________ E-mail: _______________________ Cell #: ______________________ Circle current skating level SPS 1 2 3 4 Basic Skills 1 2 3 4 5 6 Pre Free Skate Adult 1 2 3 4 STEP #1: Select Group  Snowplow Sam  Basic Skills - Girls  Pre Free Skate Basic Skills - Boys  Basic Skills – Adults  STEP #2: Select Class Date/Time Sunday 3:50-4:35 p.m. $135 $______ Tuesday 6:05-6:50 p.m. $135 $______ Thursday 6:05-6:50 p.m. $120 $______ STEP #3: Apply Discounts Save 10% if registering for 2 classes/week $______ Save 20% if registering for 3 classes/week $______ Save $5 if a subsequent family member $______ Save $5 if registering before October 29th $______ STEP #4: BASIC SKILLS Registration: $16 $______ Valid through June 30, 2018 STEP #5: Make check payable to MFSC $______ Make ups available only during Winter I 2017-18. No refunds. BRING FORM TO FIRST DAY OF CLASS OR MAIL TO: Midland Figure Skating Club: 405 Fast Ice Drive, Midland, MI 48642 Holiday Show 12/17 3:00 p.m. No Skating Nov 23 or Dec 19-31

WINTER I 2017-18 OPTIONAL PRACTICE ICE Practice ice is a great supplement to our group classes. Skaters who participate in practice ice will progress faster and have access to private lessons to receive one-on-one attention (separate coaching fees apply). LOW: Snowplow 1 through Basic 2 May schedule a 15-minute private lesson during a “MID” session. The ice cost is $6 per 15-minutes. A separate coaching fee will be paid directly to the private coach. The Skating Director has the right to restrict the sessions available for this level of skater as well as to determine a skater's readiness to participate in private lessons. Please visit our website for information on choosing a private lesson instructor. Select your sessions below MID: Basic 3-6 & Pre Free Skate (no sessions 12/17 – 12/31) Sunday 2:55-3:50 p.m. 11/5– 1/21 $162 Tuesday 5:10-6:05 p.m. 11/7 – 1/16 $162  Thursday 5:10-6:05 p.m. 11/9– 1/18 $144 HIGH: Pre Free Skate (no sessions 12/17 – 12/31)  Sunday 2:00-2:55 p.m. 11/5– 1/21 $162  Tuesday 4:30-5:10 p.m. 11/7 – 1/16 $135  Thursday 4:15-5:10 p.m. 11/9– 1/18 $144  Session Total = ________ Plus $10 Winter I Ice registration fee = ________ Registration due October 29th. After this, drop-in rate is $20 per session REFUNDS ARE NOT AVAILABLE; make up within Fall semester Private Lessons Interested in private lessons? Visit our website to find out more about our professional coaching staff: http://www.midlandfigureskatingclub.org/ Melanie Black megosk8@gmail.com Teri Haag terisk8s@yahoo.com Steve Hartsell shartsell78@hotmail.com Samantha Shriver samanthajshiring@hotmail.com   PARENTAL/SKATER CONSENT AND WAIVER OF RESPONSIBILITY   I, the undersigned parent/guardian or adult skater, agree to assume the risks of participating in the Midland Figure Skating Club Learn-to-Skate Program, and waive all claims for any personal injury and/or loss or damage to property. I hereby release the Midland Figure Skating Club, its board, members, instructors, coaches, employees and agents from any liability whatsoever, which may arise as a result of participation in the program. In the event that I am unable to be reached for immediate authorization during an emergency, I agree to hold harmless any hospital and its staff, and give permission for my child / myself to be treated by a local physician.   I understand and accept that refunds will not be offered for any reason, including medical, that the discretion of the Skating Director and instructors determines class placement for all skaters, and that skaters may be removed from activities if their behavior is deemed inappropriate or unsafe to themselves or others.   I understand and accept that it is the responsibility of the parents to pick up their children promptly at the end of class, and that the Midland Figure Skating Club, its board, members, instructors, coaches, employees and agents will not be held responsible for children left unattended.   I acknowledge that the Midland Figure Skating Club reserves the right to use photographs and/or video taken for advertising and/or instructional purposes.   I have read the waiver and hereby approve and consent to the terms and conditions stated. I further represent that I am the parent or legal guardian of the registrant(s) or that I am the adult skater, and that the information given on the registration form is complete and accurate, and I consent to the participation of the skater(s) listed.   __________________________________________________________________ Name of Skater   __________________________________________________________________ Signature of Parent, Guardian or Adult Skater Date   __________________________________________________________________ Emergency Contact Name Phone  __________________________________________________________________ Relationship to Skater __________________________________________________________________ Doctor's Name Phone  __________________________________________________________________ Existing Medical Conditions