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ROSE SKATING SCHOOL <br />WINTER/SPRING 2008-2009/ 17 WEEK SESSION <br />TUESDAY,, December 2 — April 14 <br />* No classes held on December 23 & 30, and February 17 <br />Prog # Time Level <br />9100.389 5:45pm-6:15pm Tots 3-5 years old <br />9100.390 6:15pm-6:45pm 6-8 years old <br />6:45pm — 7:00 pm RESURFACE <br />9100,391 7:00pm-7:30pm 6-8 years old <br />9100.392 7:30pm-8:00pm 9-12 years old & teens <br />SATURDAY. December 6 — ADAI 18 Poft & Nmrsation 0opcirtmeru <br />No classes held on December 27, January 31 and February 7 <br />* Please note time changes on back for January 244 * <br />Prog # <br />Time <br />Level <br />lei 9100.393 <br />1.2:00pm-12:30pm <br />Tots 3-5 years old <br />9100394 <br />12:30pm-1:00pm <br />6-8 years old <br />9100,395 <br />1:00pm-1:30pm <br />9-12 years old & teens Registration <br />Registration <br />ren <br />1:30pm - 1:45pm <br />Begins <br />RESURFACE Begins <br />9100.396 <br />1:45prn-2:15ptn <br />Freestyle 1&2 Oct. 27th <br />9100.397 <br />2:15pm-2:45pm <br />Freestyle 5 <br />9100.398 <br />2:45pm-3:15pm <br />Freestyle 3&4 <br />3:15pm - 3:30pm <br />RESURFACE <br />9100.399 <br />3:30pm4:00pm <br />Freestyle 8, 9 & 10 <br />9100.400 <br />4:00pm4:30pm <br />Freestyle 6 & 7 <br />ROSEVILLE RESIDENT FEE - $155.00 <br />NON-RESIDENT FEE - $173.00 <br />REGISTER ONLINE @ www.cityofroseville.com/skatingeenter <br />THERE ARE NO PROVISIONS FOR PRACTICE ICE OR MAKE UP CLASSES!! <br />TO AVOID A $5.00 LATE FEE - REGISTRATIONS ARE DUE BY NOVEMBER 25th. <br />An $8.00 processing charge will be added to all cancellations. <br />KEEP THE TDP FOR YOUR JNFORNIATiON <br />The Roseville Skating Center reserves the right to cancel or adjust any session due to insufficient enrollment <br />.. ............... . .. .. .. .. ............ .... . ... <br />Parent/Guardian <br />Participants Name- <br />Phone: Name: <br />Home Address: <br />City: State: Zip: <br />GENDER: F M BIRTHDATE: STATUS: New Student _ Returning TEST PASSED: <br />PROGRAM 0: PROGRAM NAME: <br />sw <br />E-MAIL: <br />ren <br />Does participant have any disability, allergy or special need of which we should be aware? Explain: <br />Z <br />Liability Waiver: I understand that participation in this activity is completely voluntary. I recognize that there are risks in my participation in this activity. <br />I agree to accept those risks. I also agree, in consideration for my being allowed to participate in this activity, and on behalf of myself, my heir, <br />executors, administrators and assigns, to release and discharge the City or Roseville, sponsor (s) of the event at activity, and their oMoors, employees, <br />agents, successors andlor assigns from liability for any and alt injury, damage or toss that is or may arise from my participation in this activity. <br />A %C <br />A& <br />Data Practtces Act Notice: Pursuant to the Minnesota Government Data Practices Act, you are being requested to furnish certain Normatlan <br />that is classified as private under the Act. The City collects such information in order to propery process requests to participate in activities. <br />You may refuse to provide such information, but such a refusal may affect your ability to participate, The information will be maintained by the <br />City Park and Recreation Department, and may be accessible to anyone in the Department, or in other Departments of the City. <br />SIGNATURE: Date: <br />Fee Paid <br />Date Paid Check # <br />BY <br />Visa or MasterCard# <br />Ex Date <br />The Roseville Skating Center reserves the right to cancel or adjust any session due to insufficient enrollment <br />