Skating Lesson Registration Name (Student)__________________________________*Age________* Address___________________City____________State___Zip_______ Phone1______________Phone2______________phone3______________ *******E-mail_______________________________________******** No refunds will be given after this lesson begins. I, Signed below, have read and agreed that I will not hold Tony K. Johnson and/or the skating facility at fault for any injury that may occur during or after this lesson. I also understand that Tony Johnson will protect my e-mail information and use it only for his tool for communication.
Student Sign (Parent if under 18)_________________________________ Parent(s) name(s): PRINT________________________________________________ This ______day of_________and the year of___________ (Please check one) Level of Experience with skating is: _____Bbeginner _____Intermediate _____Advanced 4skating@bellsouth.net 770-888-8290
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