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THE <br />GUIDA114 I JOM,i ROSE:� <br />P'A"OVA L <br />ME <br />)7' (I= 'm 11111 1 1 111 <br />Novice SIR- MI w 14T � !I . <br />Boys and girls ages 4 through 13 are invited to take part in this exciting program! Participants <br />learn the fundamentals and proper techniques of speed skating with the opportunity to take <br />part in optional weekend meets. Participants should have at least beginning level skating <br />ability. Registration is limited to the first 75 participants in each session so register early. <br />Speed Skating will be held on Tuesdays and Thursdays starting Dec grid. Register by Nov. <br />7th, <br />late registrations accepted until December 19"". No classes Dec 25th, 30 and Jan I". <br />Speed Skate fittings will be held by appointment on Thursday, Nov. 20'h 4 -bpm and <br />Saturday, Nov. 22nd 12:30-2:30pm. It is highly recommended that you attend the <br />Parent/Guardian meeting on Nov. 18th at 6:30pm at the Skating Center. Appointments for <br />skate fittings can be made at that time. <br />Program # <br />33 9100.381 Tu, Th Session 1 4:15- 5:15 pm Dec 2nd — Feb 26C' <br />tt 9100.382 Tu, Th Session H 5:30- 6:30 pin. Dec 2 d — Feb 26'h <br />U Fee:$90 Regular /$80 Roseville Resident <br />-------------------------------------------------------------------------------------------------------------------------------- <br />2008-2009 Youth Speed Skating <br />PARTICIPANT NAME: PARENTIGUARDIAN NAME: <br />ADDRESS: Crry. STATE: ZIP: PHONE: <br />EMAIL ADDRESS: <br />GENDER (circle one): F M BIRTHDATE: PROGRAM #: <br />-1 <br />Does participant have any disability, allergy ors ecial needs? Explain: <br />rA <br />Liability Walver: I understand that participation in this activity Is completely voluntary. I recognize that there are risks in my participation in this activity. I agree to <br />LO <br />MI) <br />accept those risks, I also agree, in consideration for my being allowed to participate in this activity, and on behalfalf myself, my heir, executors, administrators <br />CIO Z <br />U M cand <br />assigns, to release and discharge the City or Roseville, sponsor (s) of the event or ar.110y, and their officers, employees, agents, successors and/or assigns from <br />liability for any and all injury, damage or less that is or may arise from my participation in this activity. <br />U <br />G <br />0 <br />Data Practices Act Notice: Pursuant to the Minnesota Government Data Practices Act, you are being requested to furnish certain information that is classified as <br />'0 Ln <br />cm OZ W <br />private under the Act. The aly, col[ects such information in order 10 properly process requests: to participate in activities. You may refuse to provide such information, <br />but such a refusal may affect your ability to participate. The information will be maintained by the City Park and Recreation Department, and may be accessible to <br />anyone in the Department, or in other Departments of the Oty. <br />Signature: Date: <br />Amount Paid: Cash: Check #: Received By: <br />Visa or MasterCard#: Expiration Date: <br />Enroll on-line at www.ci.rosevijle.rnn,us/naLks, by Mail, or Fax: <br />Roseville Skating Center — 2661 Civic Center Drive — Roseville, MN 55113 <br />Phone 651-792-7007 / Fax 651-792-7120 <br />