Champions Freestyle Skater Registration Form

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1 Champions Freestyle Skater Registration Form Skater Name Date of Birth Address City State Zip Home Phone Skater USFS or Basic Skills Level Skater Cell Phone Parent/Guardian Information Primary Contact Name Relationship Cell Number Secondary Contact Name Relationship Cell Number Emercency Contact Relationship Cell Number USFS or US Basic Skills Number Exp Date * All skaters must have a USFS Full or Basic Skills membership. A Champions Basic Skills membership can be purchased for $25.00 if your current membership is expired or if you are a new member * All memberships expire June 30th of every year. Membership will not be pro-rated Please check here if you need to purchase a Champions US Basic Skills Membership $25.00 Check the boxes and sign that the skater/parent has read and understands the policies at Champions Skating Center, LLC USFS Safesport Code Of Conduct I have read and will follow the USFS SafeSport Code of Conduct. Champions Ice / Freestyle Rules I have read and will follow the Champions Ice/Freestyle Rules Liabilty Waiver and Media Release I have read, signed, and understand the waiver and media release on the back of this page X Parent Printed Name Parent Signature Date Signed X Skater Printed Name Skater Signature Date Signed Office Use Only USFS Basic Skills Payment info:

2 CHAMPIONS SKATING CENTER, LLC. WAIVER AND RELEASE OF LIABILITY In consideration of being allowed to participate in any way in the Champions Skating Center, L.L.C. programs, events, related events, and activities, the undersigned understands, appreciates, acknowledges, and agrees that: 1) The risk of injury from activities involved in these programs, events, related events, and activities is significant, including but not limited to the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISK, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3) I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4) I, for myself, and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS CHAMPIONS SKATING CENTER, L.L.C., their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event ( Releasees ), WITH RESPECT TO ANY AND ALL INJURY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. 5) I hereby grant permission to Champions Skating Center to photograph my child and use said photographs now and in the future in a brochures, Internet, multimedia presentations and newspapers concerning programs held at Champions Skating Center. I understand photos may be used without further notice or compensations, and agree that such material will be freely available for download and distribution. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. Participant s Printed Name Participant Signature Date Signed PARTICIPANTS OF MINORITY AGE (under the age of 18 years at the time of registration) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above from all the releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the releasees from any and all liabilities incident to my minor child s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE. Parent Printed Name Parent Signature Date Signed

3 Champions Skating Center Skater Code of Conduct All skaters must adhere to this Code of Conduct at all times. General Guidelines: Champions Skating Center is committed to creating a safe and positive environment for members physical, emotional and social development and ensuring that it promotes an environment free of misconduct. This Skater Code of Conduct has been established to ensure the safety of all members using our ice to ensure quality practice time for all home club, associate, non-members and guests who purchase ice from the club and who participate in all club-related activities. 1. All skaters, regardless of whether they hold home club, associate, non-member or guest status must follow and uphold the tenets in this Skater Code of Conduct regarding behavior on and off the ice. All club members are expected to exhibit good sportsmanship and be courteous toward their fellow skaters, coaches, parents of skaters, U.S. Figure Skating officials and guests. 2. Our club is committed to promoting a positive and friendly environment for all skaters. Remember The Golden Rule treat other people like you want to be treated with respect. Ice Etiquette and Safety: 1. While in lesson or practice, it is the skater's responsibility to always be conscientious and aware of other skaters around them. 2. Skaters must skate with the flow of other skaters and familiarize themselves with the most commonly used areas for jumps and spins. 3. The only time a skater has the SOLE right of way is when they are skating their program to music. When you hear another member's music, please extend that person the courtesy and move out of their path momentarily. This only takes a moment and you will enjoy the same courtesy while you are performing your program. 4. Advanced skaters are expected to exhibit patience toward beginner members of the club. Remember, you were an inexperienced skater once, and it takes time for our future generation to advance to the point where they are completely comfortable skating with all levels of skaters. Unsafe or Discourteous Behavior: Unsafe or discourteous behavior of any kind will not be tolerated.

4 Champions Skating Center Freestyle Rules General Rules All skaters must have a current USFS Basic Skills or Full Membership to skate on Champions Freestyle Session. All skaters must have a skater info sheet, waiver, and USFS Skater Code of Conduct on file with the box office All Skaters must adhere to the USFS Safesport Code of Conduct rules and guidelines Ice Rules No Game Playing NO skaters may be on the ice when the Zamboni is resurfacing. Please exit the ice promptly at the end of the session and keep rink door closed until resurfacing is completed. No standing on the ice. Skaters must stay moving at all times. Socializing needs to be conducted off of the ice or at the barrier Any skater wearing hockey skates or a helmet must be with a coach at all times All skaters must have PASSED US Basic Skills Basic 8 to be eligible to skate on a freestyle session without a coach (no age restriction) Keep the traffic flow out of lutz corners Skaters who do not follow Champions Ice/Music Rules or Safesport Code of Conduct will be warned. If the behavior continues, skaters will be removed from the ice with no refund. Skaters cannot yell Heads Up (or similar) unless imminent danger of collision exists Skaters are not permitted to use hand held devices or earphones while skating (coaches are permitted to use handheld devices to choreograph) Coaches must conduct their lessons from the barrier whenever possible and coaches must yield AT ALL TIMES to the skaters on the session. Coaches may teach group (semi-private) lessons with no more than 3 skaters. Multiple coaches teaching groups must not stand together. At the discretion of management, busy sessions may have additional group rules restrictions imposed if safety is a factor. Music Rules / Right of Way All skaters must wear a vest when doing their program Skaters on lesson only have right of way when they are on program. Every skater should have their music played once before any skater has their music played a second time. All skaters/teams have a 2 program limit per session. o Skaters may not get their music played more than once during busy sessions. o Please see rules below regarding lesson and order Restarting of music is not allowed. If you choose to play only a section of a piece of music, that is your choice, and it will count as your program. When your music is stopped, the next skater in line will played. Choreography should be done using hand held devices only. If you put the music into rotation, that will count as your program. Hand held devices must not be able to be heard above the rink system. Boom boxes that are on the barrier must not be played above the level of the skater who is on program. Music Rotation Rules o The skater on deck cannot be bumped unless they have already had their program played o Skaters on lesson have priority for their first program ONLY. A coach can only request one program per skater/team per 50 minute session o If you have a lesson and you play your program before your lesson starts, you have lost your coaches priority to have your lesson played. Please check with your coach before you request your program on a busy session o If you are the skater on deck on a busy session, please be ready to skate as quickly as possible to keep the line moving o Please do not congregate at the music box

5 CHAMPIONS ON and OFF ICE CLASSES Off-Ice Twister & Technique Class This class will incorporate the use of metal twisters/ spinners. The focus of this class will be on balance, body axis, and technique of spins and jumps. Twisters/Spinners assist the skater in learning body control. Technique is a fun way to improve on the ice skills through balance, technique of jumps, mental visualization, rhythm, and timing of jumps. Footwork and Choreography This class will deal with the skater learning new and more difficult footwork and its relationship to the music. Some weeks the focus will be on the footwork while other weeks the focus will be on learning about choreography. Choreography will include patterns on the ice, arm and hand movements, positioning of the elements within a program, and music interpretation. Moves In The Field Skaters may work on Moves in the field (no freestyle) and footwork. MUSIC IS NOT ALLOWED IMPORTANT INFORMATION All skaters must fill out a skater information sheet and waiver form (includes USFS Safesport Code of Conduct) All Skaters must obey the rules of the session (ice rules, music rules, code of conduct) All skaters must sign in PRIOR to getting on the ice Skaters must be passed USFS Basic 8 to skate on Champions Freestyle Ice (no age restrictions) Coaches must have approval prior to coaching on a session (Coaches Information Form must be completed) and a current Coaches Liability Insurance form on file with Champions Skating Center Information regarding private lessons can be obtained at the box office or by contacting the Champions Program Director at This is a general schedule annual. The current Champions Calendar can be found on Home Page of the Champions website. CHAMPIONS SKATING CENTER 6 Progress Drive Cromwell, CT Phone: Fax: :

6 Monday Wednesday (Continued) 3:30-4:20pm Freestyle 4:30-5:20pm Freestyle 5:20-5:50pm Juniors 6:00-7:00pm Off Ice Twister Class 6:00-6:50pm Learn to Skate Tuesday 3:30-4:00pm Footwork & Choreography 4:00-4:50pm Freestyle 5:00-5:50pm Freestyle Wednesday FREESTYLE and CLASS SCHEDULE (continued) 3:30-4:00pm Moves In The Field Session 4:00-4:50pm Freestyle 5:00-5:50pm Freestyle Thursday 3:30-4:20pm Freestyle 4:30-5:20pm Freestyle 5:20-5:50pm Juniors 6:00-6:50pm Learn to Skate Friday 3:30-4:20pm Freestyle 4:30-5:20pm Freestyle Saturday 9:00-9:50am Learn to Skate FREESTYLE / CLASS PRICING FREESTYLE PRICING A.M. FEES Guest Fee Coupon: $ Book (10 Coupons): $ Books (20 Coupons): $ P.M. FEES Guest Fee Coupon: $15.00 Guest Fee 1/2 Coupon: $ Book (10 Coupons): $ Books (20 Coupons): $ P.M. FEES SIBLING DISCOUNT 1 Book (10 Coupons): $ Books (20 Coupons): $ CLASS PRICING Guest Fee Coupon: $ Book (10 Coupons): $ Books (20 Coupons): $ CLASS SIBLING DISCOUNT 1 Book (10 Coupons): $ Books (20 Coupons): $190.00

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