Parent & Tot - Adult Contact Info (Ingersoll Skating Club)

Parent & Tot - Adult Contact Info

This form is to collect the Parent & Tot Adult contact information for Skate Canada Membership

Child Skater's Name:^*

Required

Please complete the following contact information for the adult that will accompany the above skater each week on the ice.

Adult Skater Name:^*

Required

Adult Skater Date of Birth:^*

Required

Address:^*

Required

City/Town:^*

Required

Postal Code:^*

Required

Phone #:^*

Required

Example: ###-###-####

E-Mail:^*

Required