Aspire Program Registration : The Skating Club of Wilmington

Skater Information

If you are completing this form for multiple skaters, 1 adult, or 1 child skater, please enter the Adult Skater/Parent/Guardian information here. Option to add children and other family members for multi skater discounts will be presented below.

Skater's Name*

First Last

Parent/Guardian

First Last

Name of the parent or guardian for any minor submitted on this application.

Contact - Name*

Contact - Phone*

Contact #2 - Name

Contact #2 - Phone

Address*

Street Address Address Line 2 City State ZIP Code

Email*

SCW Membership

SCW Club Membership

Check this box if you a SCW Club Member to receive an additional 15% discount.

YES, I am a SCW Club Member.
NO, I am NOT a SCW Club Member

Skater #1

Skater's Age (Skater #1)*

Date of Birth (Skater #1)*

Highest Basic Skill Level PASSED (Skater #1)*

If you have previously participated in a USFSA sanctioned Basic Skills Program, please select the highest level passed from the drop down.

Any USFS Skating Skills (Moves) Test Passed? (Skater #1)*

None
Pre-Preliminary
Preliminary
Pre-Bronze (formerly Pre-Juvenile MIF)
Bronze (formerly Juvenile MIF)

Any USFS Singles (Free Skating) Test Passed? (Skater #1)*

None
Pre-Preliminary
Preliminary

Any USFS Dance Test Passed? (Skater #1)*

None
Pre-Preliminary (partial)
Pre-Preliminary (DW, CT, and RB)
Pre-Bronze (partial)
Pre-Bronze (SD, CC, FiT)

Name of Private Coach(es) (Skater #1)

if applicable. List all separated by commas.

I have discussed my participation in the ASPIRE Program with my private coach(es) (Skater #1):*

*Please discuss your skater’s participation with any current private instructors, before registering.

YES
NO

Any Medical Conditions (Skater #1)

Emergency Contact - Name (Skater #1)

Emergency Contact - Phone (Skater #1)

Program Selection (Skater #1)*

Program Selection (Skater #1 member)*

Day/Schedule Selection (Skater #1)*

Select a schedule for Plan A

Day/Schedule Selection (Skater #1 member)*

Select a schedule for Plan A

Day/Schedule w/Off-Ice Selection (Skater #1)*

Select a schedule for Plan B or D

Day/Schedule w/Off-Ice Selection (Skater #1 member)*

Select a schedule for Plan B or D

Preferred Off-Ice time - Sundays (Skater #1)*

B or D

Preferred Off-Ice time - Sundays (Skater #1)*

Select a schedule for Plan C Sundays

Preferred Off-Ice time - Sundays (Skater #1 member)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #1 member)*

Select a schedule for Plan C Sundays

Preferred Off-Ice time - Wednesdays (Skater #1)*

Plan B or D

Preferred Off-Ice time - Wednesdays (Skater #1)*

Select a schedule for Plan C Wednesdays

Preferred Off-Ice time - Wednesdays (Skater #1 member)*

Plan B or D

Preferred Off-Ice time - Wednesdays (Skater #1 member)*

Select a schedule for Plan C Wednesdays

Payment Option - PLAN A (Skater #1)*

Choose an option:
Full payment OR 5 installments
- $712.50 (Paid in full - 5% discount
- $150 - 1st installment (plus 4 x $150 = $750 billed separately)

Payment Option - PLAN A (Skater #1 member)*

Choose an option:
Full payment OR 5 installments
- $605.63 (Paid in full - 5% discount
- $127.50 - 1st installment (plus 4 x $127.50 = $637.50 billed separately)

Payment Option - PLAN B (Skater #1)*

Choose an option:
Full payment OR 5 installments
- $950 (Paid in full - 5% discount
- $200 - 1st installment (plus 4 x $200 = $1,000 billed separately)

Payment Option - PLAN B (Skater #1 member)*

Choose an option:
Full payment OR 5 installments
- $807.50 (Paid in full - 5% discount
- $170 - 1st installment (plus 4 x $170 = $850 billed separately)

Payment Option - PLAN C (Skater #1)*

Choose an option:
Full payment OR 5 installments
- $1710 (Paid in full - 5% discount
- $360 - 1st installment (plus 4 x $360 = $1,800 billed separately)

Payment Option - PLAN C (Skater #1 member)*

Choose an option:
Full payment OR 5 installments
- $1453.50 (Paid in full - 5% discount
- $306 - 1st installment (plus 4 x $306 = $1,530 billed separately)

Payment Option - PLAN D (Skater #1)*

Choose an option:
Full payment OR 5 installments
- $285 (Paid in full - 5% discount
- $60 - 1st installment (plus 4 x $60 = $300 billed separately)

Payment Option - PLAN D (Skater #1 member)*

Choose an option:
Full payment OR 5 installments
- $285 (Paid in full - 5% discount
- $60 - 1st installment (plus 4 x $60 = $300 billed separately)

Additional Family Members

Discount for multiple skaters from the same household:
Add additional skaters for 10% off (non-members only)

Skater #2

Name (Skater #2)*

First Last

Skater's Age (Skater #2)*

Date of Birth (Skater #2)*

Highest Basic Skill Level PASSED (Skater #2)*

If you have previously participated in a USFSA sanctioned Basic Skills Program, please select the highest level passed from the drop down.

Any USFS Skating Skills (Moves) Test Passed? (Skater #2)*

None
Pre-Preliminary
Preliminary
Pre-Bronze (formerly Pre-Juvenile MIF)
Bronze (formerly Juvenile MIF)

Any USFS Singles (Free Skating) Test Passed? (Skater #2)*

None
Pre-Preliminary
Preliminary

Any USFS Dance Test Passed? (Skater #2)*

None
Pre-Preliminary (partial)
Pre-Preliminary (DW, CT, and RB)
Pre-Bronze (partial)
Pre-Bronze (SD, CC, FiT)

Name of Private Coach(es) (Skater #2)

if applicable. List all separated by commas.

I have discussed my participation in the ASPIRE Program with my private coach(es) (Skater #2):*

*Please discuss your skater’s participation with any current private instructors, before registering.

YES
NO

Any Medical Conditions (Skater #2)

Emergency Contact - Name (Skater #2)

Emergency Contact - Phone (Skater #2)

Program Selection (Skater #2)*

Program Selection (Skater #2 member)*

Day/Schedule Selection (Skater #2)*

A

Day/Schedule Selection (Skater #2 member)*

A

Day/Schedule w/Off-Ice Selection (Skater #2)*

Plan B or D

Day/Schedule w/Off-Ice Selection (Skater #2 member)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #2)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #2)*

Select a schedule for Plan C Sundays

Preferred Off-Ice time - Sundays (Skater #2 member)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #2 member)*

Select a schedule for Plan C Sundays

Preferred Off-Ice time - Wednesdays (Skater #2)*

Plan B or D

Preferred Off-Ice time - Wednesdays (Skater #2)*

Select a schedule for Plan C Wednesdays

Preferred Off-Ice time - Wednesdays (Skater #2 member)*

Plan B or D

Preferred Off-Ice time - Wednesdays (Skater #2 member)*

Select a schedule for Plan C Wednesdays

Payment Option - PLAN A (Skater #2)*

Choose an option:
Full payment OR 5 installments
- $641.25 (Paid in full - 5% discount
- $135 - 1st installment (plus 4 x $135 = $675 billed separately)

Payment Option - PLAN A (Skater #2 member)*

Choose an option:
Full payment OR 5 installments
- $605.63 (Paid in full - 5% discount
- $127.50 - 1st installment (plus 4 x $127.50 = $637.505 billed separately)

Payment Option - PLAN B (Skater #2)*

Choose an option:
Full payment OR 5 installments
- $855 (Paid in full - 5% discount
- $180 - 1st installment (plus 4 x $180 = $900 billed separately)

Payment Option - PLAN B (Skater #2 member)*

Choose an option:
Full payment OR 5 installments
- $807.50 (Paid in full - 5% discount
- $170 - 1st installment (plus 4 x $170 = $850 billed separately)

Payment Option - PLAN C (Skater #2)*

Choose an option:
Full payment OR 5 installments
- $1,539 (Paid in full - 5% discount
- $324 - 1st installment (plus 4 x $324 = $1,620 billed separately)

Payment Option - PLAN C (Skater #2 member)*

Choose an option:
Full payment OR 5 installments
- $1,453.50 (Paid in full - 5% discount
- $306 - 1st installment (plus 4 x $306 = $1,530 billed separately)

Payment Option - PLAN D (Skater #2)*

Choose an option:
Full payment OR 5 installments
- $285 (Paid in full - 5% discount
- $60 - 1st installment (plus 4 x $60 = $285 billed separately)

Payment Option - PLAN D (Skater #2 member)*

Choose an option:
Full payment OR 5 installments
- $285 (Paid in full - 5% discount
- $60 - 1st installment (plus 4 x $60 = $285 billed separately)

Skater #3

Name (Skater #3)*

First Last

Skater's Age (Skater #3)*

Date of Birth (Skater #3)*

Highest Basic Skill Level PASSED (Skater #3)*

If you have previously participated in a USFSA sanctioned Basic Skills Program, please select the highest level passed from the drop down.

Any USFS Skating Skills (Moves) Test Passed? (Skater #3)*

None
Pre-Preliminary
Preliminary
Pre-Bronze (formerly Pre-Juvenile MIF)
Bronze (formerly Juvenile MIF)

Any USFS Singles (Free Skating) Test Passed? (Skater #3)*

None
Pre-Preliminary
Preliminary

Any USFS Dance Test Passed? (Skater #3)*

None
Pre-Preliminary (partial)
Pre-Preliminary (DW, CT, and RB)
Pre-Bronze (partial)
Pre-Bronze (SD, CC, FiT)

Name of Private Coach(es) (Skater #3)

if applicable. List all separated by commas.

I have discussed my participation in the ASPIRE Program with my private coach(es) (Skater #3):*

*Please discuss your skater’s participation with any current private instructors, before registering.

YES
NO

Any Medical Conditions (Skater #3)

Emergency Contact - Phone (Skater #3)

Emergency Contact - Name (Skater #3)

Program Selection (Skater #3)*

Program Selection (Skater #3 member)*

Day/Schedule Selection (Skater #3)*

A

Day/Schedule Selection (Skater #3 member)*

A

Day/Schedule w/Off-Ice Selection (Skater #3)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #3)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #3)*

Select a schedule for Plan C Sunday

Preferred Off-Ice time - Sundays (Skater #3 member)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #3 member)*

Select a schedule for Plan C Sunday

Preferred Off-Ice time - Wednesdays (Skater #3)*

Plan B or D

Preferred Off-Ice time - Wednesdays (Skater #3 member)*

Plan B or D

Preferred Off-Ice time - Wednesdays (Skater #3)*

Select a schedule for Plan C Wednesday

Preferred Off-Ice time - Wednesdays (Skater #3 member)*

Select a schedule for Plan C Wednesday

Payment Option - PLAN A (Skater #3)*

Choose an option:
Full payment OR 5 installments
- $641.25 (Paid in full - 5% discount
- $135 - 1st installment (plus 4 x $135 = $675 billed separately)

Payment Option - PLAN A (Skater #3 member)*

Choose an option:
Full payment OR 5 installments
- $637.50 (Paid in full - 5% discount
- $127.50 - 1st installment (plus 4 x $127.50 = $637.50 billed separately)

Payment Option - PLAN B (Skater #3)*

Choose an option:
Full payment OR 5 installments
- $855 (Paid in full - 5% discount
- $180 - 1st installment (plus 4 x $180 = $900 billed separately)

Payment Option - PLAN B (Skater #3 member)*

Choose an option:
Full payment OR 5 installments
- $807.50 (Paid in full - 5% discount
- $170 - 1st installment (plus 4 x $170 = $850 billed separately)

Payment Option - PLAN C (Skater #3)*

Choose an option:
Full payment OR 5 installments
- $1539 (Paid in full - 5% discount
- $324 - 1st installment (plus 4 x $324 = $1,620 billed separately)

Payment Option - PLAN C (Skater #3 member)*

Choose an option:
Full payment OR 5 installments
- $1,453.50 (Paid in full - 5% discount
- $306 - 1st installment (plus 4 x $306 = $1,530 billed separately)

Payment Option - PLAN D (Skater #3)*

Choose an option:
Full payment OR 5 installments
- $285 (Paid in full - 5% discount
- $60 - 1st installment (plus 4 x $60 = $300 billed separately)

Payment Option - PLAN D (Skater #3 member)*

Choose an option:
Full payment OR 5 installments
- $285 (Paid in full - 5% discount
- $60 - 1st installment (plus 4 x $60 = $300 billed separately)

Skater #4

Name (Skater #4)*

First Last

Skater's Age (Skater #4)*

Date of Birth (Skater #4)*

Highest Basic Skill Level PASSED (Skater #4)*

If you have previously participated in a USFSA sanctioned Basic Skills Program, please select the highest level passed from the drop down.

Any USFS Skating Skills (Moves) Test Passed? (Skater #4)*

None
Pre-Preliminary
Preliminary
Pre-Bronze (formerly Pre-Juvenile MIF)
Bronze (formerly Juvenile MIF)

Any USFS Singles (Free Skating) Test Passed? (Skater #4)*

None
Pre-Preliminary
Preliminary

Any USFS Dance Test Passed? (Skater #4)*

None
Pre-Preliminary (partial)
Pre-Preliminary (DW, CT, and RB)
Pre-Bronze (partial)
Pre-Bronze (SD, CC, FiT)

Name of Private Coach(es) (Skater #4)

if applicable. List all separated by commas.

I have discussed my participation in the ASPIRE Program with my private coach(es) (Skater #4):*

*Please discuss your skater’s participation with any current private instructors, before registering.

YES
NO

Any Medical Conditions (Skater #4)

Emergency Contact - Phone (Skater #4)

Emergency Contact - Name (Skater #4)

Program Selection (Skater #4)*

Program Selection (Skater #4 member)*

Day/Schedule Selection (Skater #4)*

A

Day/Schedule Selection (Skater #4 member)*

A

Day/Schedule w/Off-Ice Selection (Skater #4)*

Plan B or D

Day/Schedule w/Off-Ice Selection (Skater #4 member)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #4)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #4)*

Select a schedule for Plan C Sunday

Preferred Off-Ice time - Sundays (Skater #4 member)*

Plan B or D

Preferred Off-Ice time - Sundays (Skater #4 member)*

Select a schedule for Plan C Sunday

Preferred Off-Ice time - Wednesdays (Skater #4)*

Plan B or D

Preferred Off-Ice time - Wednesdays (Skater #4)*

Select a schedule for Plan C Wednesday

Preferred Off-Ice time - Wednesdays (Skater #4 member)*

Plan B or D

Preferred Off-Ice time - Wednesdays (Skater #4 member)*

Select a schedule for Plan C Wednesday

Payment Option - PLAN A (Skater #4)*

Choose an option:
Full payment OR 5 installments
- $641.25 (Paid in full - 5% discount
- $135 - 1st installment (plus 4 x $135 = $675 billed separately)

Payment Option - PLAN A (Skater #4 member)*

Choose an option:
Full payment OR 5 installments
- $637.50 (Paid in full - 5% discount
- $127.50 - 1st installment (plus 4 x $127.50 = $637.50 billed separately)

Payment Option - PLAN B (Skater #4)*

Choose an option:
Full payment OR 5 installments
- $855 (Paid in full - 5% discount
- $180 - 1st installment (plus 4 x $180 = $900 billed separately)

Payment Option - PLAN B (Skater #4 member)*

Choose an option:
Full payment OR 5 installments
- $807.50 (Paid in full - 5% discount
- $170 - 1st installment (plus 4 x $170 = $850 billed separately)

Payment Option - PLAN C (Skater #4)*

Choose an option:
Full payment OR 5 installments
- $1539 (Paid in full - 5% discount
- $324 - 1st installment (plus 4 x $324 = $1,620 billed separately)

Payment Option - PLAN C (Skater #4 member)*

Choose an option:
Full payment OR 5 installments
- $1,453.50 (Paid in full - 5% discount
- $306 - 1st installment (plus 4 x $306 = $1,530 billed separately)

Payment Option - PLAN D (Skater #4)*

Choose an option:
Full payment OR 5 installments
- $285 (Paid in full - 5% discount
- $60 - 1st installment (plus 4 x $60 = $300 billed separately)

Payment Option - PLAN D (Skater #4 member)*

Choose an option:
Full payment OR 5 installments
- $285 (Paid in full - 5% discount
- $60 - 1st installment (plus 4 x $60 = $300 billed separately)

Payment

Comments

Please add any comments that will help us process your order.

Photo and Video Release*

The Skating Club of Wilmington reserves the right to use images of our skaters as part of social media, on our website or for publicity purposes. By submitting this registration, you acknowledge and give us permission to do so.

I agree to the photo and video release for all skaters submitted with this registration.

Disclaimer*

You recognize that The Skating Club of Wilmington is not liable for injury during participation in any activity or theft of personal belongings. All registrations are final. NO REFUNDS. Make-up classes are limited to 5 in the 30 week program. No make-up classes for ASPIRE EDGE package.

Yes, I have read and agree to the above Disclaimer.

Total

$0.00

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