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NWT SUMMER SPEED SKATING SUMMER CAMP
CAMP DATES: August 19-23, 2015
CAMP HOURS: (these may vary slightly due to City of Yk ice schedule)
GROUP I
9:00 am – 10:30 am on-ice
12:30 pm - 2:00 pm dryland training
4:30 pm - 6:00 pm on-ice
GROUP 2
12:30 pm – 2:00 pm dryland training
3:00 pm – 4:30 pm on-ice
Pick up 5pm @ Multiplex
REGISTRATION:
Send registration forms and cheques to:
NWTASSA, PO Box 2664, X1A 2P9 or drop off at 5204 Lundquist Rd, Yellowknife.
Please make cheques payable to NWTASSA
Your cheque is required to confirm your camp registration.
Camp fees ($200) are non- refundable after the registration deadline, June 30,
2015.
Group 1 additional ice fees of $30 will be collected on the first day of camp (cash
or cheques payable to NWTASSA Summer Camp 2015).
Group 2 skaters will be chaperoned and escorted from dryland (held at William
McDonald School track) to their ice session at the multiplex. Pick up is at the multiplex
by 5 pm.
Camp is open to skaters 9 years and older as of September 30, 2015. Skaters will be
divided into two groups after all registrations are received.
VOLUNTEERS needed to assist with the camp BBQ: Please
contact Kelsie (nwtspeedskating@gmail.com)
NWT SUMMER SPEED SKATING SUMMER CAMP REGISTRATION FORM
NAME:
PARENT/GUARDIAN:
HOME PHONE: WORK/CELL PHONE:
EMAIL:
ADDRESS:
CITY/TOWN: POSTAL CODE:
AGE:
HEALTH CARE NUMBER:
BIRTHDATE:
EMERGENCY CONTACT DURING THE DAY:
NAME:
TELEPHONE:
PLEASE DETAIL ANY SPECIAL CONSIDERATIONS:
T-Shirt SIZE:
ADULT: S___ M____L___ XL ___ XXL ___
YOUTH: S___ M___ L___
SEED TIMES:
Junior (Born July 1, 1994 – June 30, 1998): BEST 500m time from 2013/14 season
on 111m TRACK: ________________
T2T and below (Born July 1, 1998 – September 30, 2005): Best 500m time from
2013/14 season on 100m TRACK: ___________________
OTHER INFORMATION:
# Of family members attending end-of-camp BBQ _____
Please check if you can help with:
____ Putting mats on the ice
____ Doing water at the rink
____ Assisting in supervision of Group 2 skaters
Waiver
By signing this registration form, I hereby for myself, my heirs, executors, administrators
and assigns, waive and release any and all right and claims for damages I may have
against the Yellowknife Speed Skating Club, NWT Amateur Speed Skating Association,
Speed Skating Canada, camp organizing committee, City of Yellowknife and other
organizations and sponsors concerned, their agents, officers, employees, volunteers or
members for any and all injuries suffered by me at the NWTASSA Speed Skating Camp
2015 to be held August 19-23, 2015 in Yellowknife, NT, Canada.
This information is collected under the authority of the Freedom of Information and
Protection of Privacy Act. It is required to register you in the camp. Financial information
will be used to process payment. Organization of competitions/events requires that
names will appear on posted race lists and results printouts. Names/images of
participants may be published on boards, websites, media, newsletters and promotional
materials. Alternative contact and medical information will only be used in a medical
emergency. If you have questions about the collection of or the use of this information,
contact the camp organizer.
In witness whereof, I have here unto set my hand this day of
________________, 2015
________________________________ OR ________________________
Signature of parent
Signature of skater (over 18 yrs)