"Catch A Rising Star!"
Skater Name:
USFS #: Birthdate:
Address:
City: State: Zip:
Phone: Email:
Parent/Guardian Name(s):
Emergency Phone #:
Please Indicate the Camp Package you wish to sign up for. All packages include one on ice group class and one off ice group class per day in addition to the number of freestyles indicated. For more information about the summer camp, please refer to the printable registration form on the previous page.
Summer Camp A (5 Freestyles) $195.00 Summer Camp B (8 Freestyles) $225.00 Summer Camp C (10 Freestyles) $245.00 Summer Camp D (13 Freestyles) $275.00 Summer Camp E (15 Freestyles) $295.00
Please Choose the Freestyles you would like to attend on each day of camp. The total number of freestyles selected should correspond with the number of freestyle offered with your Camp Package above.
9:55-10:55 12:00-1:00 1:00-2:00 9:55-10:55 12:00-1:00 1:00-2:00 9:55-10:55 12:00-1:00 1:00-2:00 9:55-10:55 12:00-1:00 1:00-2:00 9:55-10:55 12:00-1:00 1:00-2:00
Private Lesson Information:
All private lessons given during freestyle times will be billed to skaters at the completion of camp. Please pay your coach directly for their services.
1st Choice Coach 2nd Choice Coach
Abby Loeffelholz $30.00/hr Carrie Schaefer $24.00/hr April Cutsforth $21.00/hr Dane Bowlin $18.00/hr Karen Heinselman $18.00/hr Abby Loeffelholz $30.00/hr Carrie Schaefer $24.00/hr April Cutsforth $21.00/hr Dane Bowlin $18.00/hr Karen Heinselman $18.00/hr
Number of lessons Desired for the week
Special Requests
Parent/Guardian Permission:
By checking the box to the left, I hereby waive all claims against the CVFSC for injury suffered on
or off the ice, and I assumer all risks and hazards incidental with participation in this camp.
Total Registration Fees:
Please mail payments to:
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