Yost Ice Arena - Program Registration Form

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)
___  Summer Session:  July 13 - August 17, 2008   ($66.00)
___  Fall/Winter Session #1:
___  Fall/Winter Session #2:
___  Fall/Winter Session #3:
___  Fall/Winter Session #4:
          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 thereunder.

Participant's Signature ______________________________________________________________ Date ________________

Parent/Guardian's Signature ______________________________________________________________ Date ________________