"BRUNO`S JUMP TECH SEMINAR" REGISTRATION FORM

"BRUNO’S JUMP TECH SEMINAR" REGISTRATION FORM - NOV 30TH
--------------------------------------------------------------------------------------------------------------------------Skater’s Name: _______________________________________________________________
Mailing Address: ______________________________________________________________
City: ____________________________________ Postal Code: _______________
Phone: _________________________________ Cell Phone: _____________________________
E-mail: ________________________________________________________________________
Coach: _______________________________________________________________________
Coaches e-mail: ______________________________ Coaches Phone: ____________________
Age: ______________________________ Date of Birth: _________________________________
Highest Freeskate Test Passed: ___________________________________________________
Skate Canada⋕_______________________Medical⋕__________________________________
Please circle the following jumps that you are landing consistently:
Waltz Jump
Flip
Double ToeLoop
Double Axel
Salchow
Lutz
Double Loop
Triple Salchow
ToeLoop
Axel
Double Flip
Triple ToeLoop
Loop
Double Salchow
Double Lutz
Triple Loop
***Coaches signature for above: ________________________________***
What off-ice training has been done in the past: (eg. ballet, jump technique, strength, yoga)
_________________________________________________________________________________
_________________________________________________________________________________
____
How often is off-ice completed:
Off-Season
Seminars/Inconsistent basis
In-Season - (minimum of 2-3 times/wk)
PO Box 712, Station A Prince George, BC V2L 4T3
skateprincegeorge.com
250.962.1993
"BRUNO’S JUMP TECH SEMINAR" REGISTRATION FORM - NOV 30TH
Is a dynamic warm-up completed on a regular basis (minimum of 3-4 times/week):
Yes
No
Unsure
**********************************************************************************************************
Registration Fee payable to SCSC: $100
E-mail Confirmation: [email protected]
Nicole Callaway: Events Chair - Spruce City Skating Club
250.962.1993.
DEADLINE: Tues Nov 27th at 5pm. Space is limited - sign up today! Participation will be limited
to a maximum of 30 STAR 3 and up skaters, although special consideration will be made if
space is available.
The Spruce City Skating Club, all facilitators, Skate Canada and the City of Prince George are
not responsible for accidents and/or injuries to participants or guests. By signing below I also
consent to a photo/video release for PR purposes.
Name of Parent/Guardian: ___________________
Signature of Parent/Guardian: _____________________
Date: ______________
Please bring:
Training binder, loose leaf paper, pencil, eraser, water bottle, running shoes, yoga mat, POSITIVE
ATTITUDE!
*PLEASE BE ON TIME FOR ALL SESSIONS!*
PO Box 712, Station A Prince George, BC V2L 4T3
skateprincegeorge.com
250.962.1993