Skater Name:

USFS #:      Birthdate: 

Address: 

City:    State:     Zip:

Phone:     Email:  

Please Indicate the Session(s) you wish to register for:

Learn to Skate:                                       Freestyle:

5 Week Session                                       July 29-August 31

          July 30-August 27

Mondays 5:30-6:20 pm $50.00                     Sunday 4:45-5:30 pm $50.00 Sunday 5:30-6:15 pm $50.00 Monday 6:30-7:15 pm $50.00 Monday 7:15-8:00 pm $50.00 Thursday 5:30-6:15 pm $50.00 Thursday 6:15-7:00 pm $50.00

Summer Freestyle Coupons                        $60.00

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

**Registration forms need to be turned in by July 16, 2007 along with your total fees to avoid a $25.00 late registration fee.  In addition, any remaining balance with the club or coaches from previous session(s) must be paid in full BEFORE the summer session begins.

Total Registration Fees: 

Please mail payments to:

CVFSC Test Session

          P.O. Box 1052

Waterloo, IA  50704