Glacier Blades Registration Form

Name:
Address:
City:
Zip:
Tel:(H)
Tel:(B)
E-Mail:
Date of Birth
Check the Following:
Learn to skate
Learn to Play Hockey
Learn to Play Hockey & Learn to Skate
Basic Skills
Power Skating
Basic Skills – 2
I, the parent or legal guardian, waive all claims against Glacier Pointe and its employees for any loss or injury resulting from participating in this program.