DONNA MITCHELL
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XL CENTER
HARTFORD, CT
SATURDAY DECEMBER 9, 2017
1 - 4 PM
ALL PARTICIPATING SKATER'S MUST FILL OUT
THIS INFORMATION FORM
Please fill out sections 1 - 3. If you are unable to SUBMIT, you've missed a required field/question indicated with a red *.
Section 1: IMPORTANT INFORMATION
Required Fields have a red *
*
Indicates required field
Skater's Name
*
First
Last
[object Object]
If applicable - Please list your Dance or Pair Partner's name or if you are skating a small group/duet,etc
*
Skater's Date of Birth
*
Basic Skills or Full USFS Member?
*
Skater has a current US Basic Skills #
Skater has a current US Figure Skating #
Skater is not current and I need to get a #
Please provide # if you have one
*
USFS Club (please state Home Club) or Individual Member?
*
Highest Freestyle Test Passed
*
N/A
Pre-Preliminary
Preliminary
Pre-Juvenile
Juvenile
Intermediate
Novice
Junior
Senior
Highest Moves in the Field Test Passed
*
N/A
Pre-Preliminary
Preliminary
Pre-Juvenile
Juvenile
Intermediate
Novice
Junior
Senior
Highest level Dance Test passed
*
N/A
Preliminary
Pre-Bronze
Bronze
Pre-Silver
Silver
Pre-Gold
Gold
International
If a competitive Dance Team, what level?
*
N/A
Juvenile
Intermediate
Novice
Junior
Senior
If a competitive Pair Team, what level?
*
N/A
Juvenile
Intermediate
Novice
Junior
Senior
If skating with a team/group, please list name of group/team(s)
*
Section 2: Required Fields have a red *
Select One
*
Mom
Dad
Adult Skater
Grandparent
Gaurdian
Other
Name
*
First
Last
[object Object]
Email
*
Select One
*
Cell
Home
Work
Other
Phone Number
*
Skater's Email OPTIONAL
*
Additional Email OPTIONAL
*
Skater's Cell Phone # OPTIONAL
*
Additional Phone Number OPTIONAL
*
Cell
Home
Work
Additional Phone Number OPTIONAL
*
Section 3 Required Fields have a red *
Please list your song choice if you know it or any additional comments or important information
*
TO COMPLETE YOUR REGISTRATION, CLICK HERE TO SUBMIT
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