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tryout Submission form 2021-2022

* Indicates required field

Skater Name *

First

Last

Skater Email *

Skater USFSA Number *

Skater age as of July 1, 2021 *

Skater Birthdate *

Skater Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian Name *

First

Last

[object Object]

Parent/Guardian Email *

Parent/Guardian Name 2 *

First

Last

[object Object]

Parent/Guardian Email 2 *

Skater Phone Number (text reminders) *

Parent Phone Number (text reminders) *

Parent 2 Phone Number (text reminders) *

Highest Moves in the Field PASSED *

Highest Dance Level PASSED *

Highest Freestyle Level PASSED *

Which Team(s) are you trying out for? *We are not fielding all these teams. Just possible options. *

Beginner/Aspire Preliminary Pre Juvenile Open Juvenile Juvenile Intermediate Novice Junior Adult Masters Collegiate

Primary Coach's Name *

First

Last

Primary Coach's Email *

Primary Coach's Phone Number *

In case of emergency who should we contact? *

First

Last

Their Phone Number *

Payments will need to be made via contactless option. Contact starlitblades@gmail.com directly if you have any questions. *

Venmo payment to @EllieNielsen17 Credit card using Square (3% service fee. Email invoice will be sent within 1 week for you to pay online)

Please sign name below acknowledging that you have read and agree to the terms of the 2021 Release Form located below. Your signature also acknowledges that you understand coaches/staff are taking precautions to avoid exposure of skaters to Covid-19, and that you will not hold coaches/staff liable in the case that you/your skater is exposed to Covid-19. *

Any comments, questions, or concerns? *

Submit

tryout_release.pdf
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