Individual Membership

This is a *New membershipRenewal

First Name *

Last Name *

Age *12 and under13 to 1516 to 1718 and over

Gender *MaleFemaleNon-binaryI'd prefer not to say

Skater? *YesNo

Ethnicity

Address *

Town/City *

Postcode *

Country *

Your email *

Your Phone Number *

Parent/Guardian (name and phone number) *

Emergency Contact (name & phone number) *In case of emergency when skating during club ice, please provide emergency contact details.

RELEASE OF LIABILITY AND WAIVER OF ALL CLAIMS *I/Parent/Guardian understand and acknowledge that there are risks involved in ice skating and assume full responsibility for any associated risks while participating in ice skating training or figure skating sessions through Wellington Figure Skating Club (WFSC). I/Parent/Guardian agree that to the extent permissible by law, WFSC and other parties associated with WFSC training and events, have no liability to me/my child whatsoever for any direct or indirect loss, (including, but not limited to injury, death or loss of property), related to my participation in WFSC training or events. I/Parent/Guardian/Child agree to follow all rules posted at the rink and surrounding areas, and instructions from Coaches, WFSC Committee and the operating staff of the rink.

Payment method *Credit CardBank Deposit

Bank Deposit

Bank deposit details

Credit / Debit Card *

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