(Partners must complete separate entry forms)
| Name: | USFSA# or CFSA#: | Sex: F M | ||||||||||
| Address: | City: | State/Zip Code: | ||||||||||
| U.S Citizen? Yes No Canadian Citizen? Yes No | E-mail address: | |||||||||||
| Home Club: | Age on 3/3/00: | Date of Birth: | ||||||||||
| Phone Number Day: ( ) | Phone Number Evening: ( ) | |||||||||||
| Name of Coach: | Coach's Phone Number: ( ) | |||||||||||
| Name of Partner: | Partner's Phone Number ( ) | |||||||||||
Highest
Test Passed:
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| Please check off the event(s) you wish to enter: | ||||
| Age Class | Free Skating | Dance | Interpretive | A COMPLETE ENTRY WILL |
| __ I | __ Masters Senior | __ Adult Gold | __ Masters | CONTAIN THE FOLLOWING |
| __ II | __ Masters Junior | __ Adult Pre-Gold | __ Adult | __ Entry Form (completed) |
| __ III | __ Masters Novice | __ Adult Silver | __ Proof of Age (copy) | |
| __ Adult Bronze | __ Entry Fees (check) | |||
| Event: | __ Adult Gold | __ Adult Pre-Bronze | ||
| __ Men | __ Adult Silver | Entry Fees: | ||
| __ Ladies | __ Adult Bronze | Pair: | $60.00 US - First Singles Event | |
| __ Adult | $35.00 US - Second Singles Event | |||
| __ Masters | $80.00 US - Per Team: Pairs or Dance | |||
Enclosed is a check for $ ____________________ in US dollars.
| Make checks payable to: TEAM SEATTLE |
Deadline for postmark is March 3, 2001 |
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PLEASE MAIL TO: |
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Team Seattle |
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Accidents and Liability:
TEAM SEATTLE, the Slide for Pride 2001 Organizing Committee, the Sno-King
Amateur Hockey Association, Inc. and The Kingsgate Ice Arena undertake no
responsibility for damages or injuries suffered by skaters or officials. As a
condition of and in consideration of the acceptance of entries or participation,
all entrants, family members, coaches and officials shall be deemed to agree to
assume all risks of injury to their person and property resulting from, caused
by, or connected with the conduct or management of the exhibition. Entries will
be accepted only under such condition.
| Signature of Skater: | Date: |