Yost Ice Arena Programs
Registration Form
(print and mail completed form with payment to Yost Ice Arena, 1000 S. State St., Ann Arbor, MI 48109)
 

Participant's Name:

_____________________________________________________________________________

Age:

 _____________________________________________________________________________
Street Address:
_____________________________________________________________________________
_____________________________________________________________________________
City:
_____________________________________  State:  ______________  Zip:  ______________
Phone:
 _____________________________________________________________________________
Email:
 _____________________________________________________________________________


Please mark ('X') the program(s) you are registering for:
     

Learn to Skate
          (6 classes per session)
 ___  Fall/Winter Session #1:  September 14th, 2008-October 19, 2008
___  Fall/Winter Session #2:  October 26, 2008-December 7, 2008 (no class November 30)
___  Fall/Winter Session #3:  January 11, 2009-February 15, 2009
___  Fall/Winter Session #4:  March 8, 2009-April 12, 2009
          Last Level Passed:    _________________________________
          Skating Experience:  _________________________________
 
Amount Enclosed:  $__________  (please make check payable to Yost Ice Arena)


AGREEMENT TO PARTICIPATE
I/we agree to release Yost Ice Arena, Yost Ice Arena programs, the University of Michigan, the University of Michigan Athletic Department and
employees from all claims, actions, causes of actions and damages by the undersigned person, their parents/guardians for loss or injury
resulting directly from the participation of such person in this program.  I further agree to indemnify and save harmless such parties from all
claims, actions, damages, or demands, including all costs and expenses incurred in defending any such claims or actions. I have read the
release and understand this is a full and final release of all claims for injury and damages sustained in Yost Ice Arena and have read over
the agreement and understand the responsibilities I have assumed there under.
Participant's Signature  ______________________________________________________________   Date ________________       
Parent/Guardian's Signature  ______________________________________________________________   Date ________________