Winona Figure Skating Club Online Registration

Registration

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Welcome to Winona Figure Skating! Please provide your contact information and course registration below. All registrations will be considered pending until payment has been received. Payment methods are by Credit Card, Debit Card, and Check only

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)*

Health Insurance Carrier

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Grade

Primary Doctor*

USFS Member #

Learn to Skate #

Hockey Learn to Skate #

Please select your course and session you'd like to register for. (Sessions may be selected individually or you may choose the all sessions option.) Membership MUST accompany your initial registration or it will automatically be added to your account.

Accounts not paid in full by the end of February will be charged to the card on file with the club.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Grade

Primary Doctor*

USFS Member #

Learn to Skate #

Hockey Learn to Skate #

Accounts not paid in full by the end of February will be charged to the card on file with the club.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Grade

Primary Doctor*

USFS Member #

Learn to Skate #

Hockey Learn to Skate #

Accounts not paid in full by the end of February will be charged to the card on file with the club.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Grade

Primary Doctor*

USFS Member #

Learn to Skate #

Hockey Learn to Skate #

Accounts not paid in full by the end of February will be charged to the card on file with the club.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Grade

Primary Doctor*

USFS Member #

Learn to Skate #

Hockey Learn to Skate #

Accounts not paid in full by the end of February will be charged to the card on file with the club.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

Membership Type*

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

Required Policies

(Show-Hide Details)