SKATES' OUT Check Out

Student 1 First Name*
Student 1 Last Name*
Student 2 First Name
Student 2 Last Name
Email*
Phone*
Address*
City*
State*
Zip*
Will this be your first time on skates?*
Location*
Shoe Size*
How long have you been skating?
Pick a Summer Skate Camp 2017 Week
Pick a Skate Camp (if applicable)
What is it that you're wanting to accomplish by the end of the four week program?
Do you have any type of health conditions that would prevent you from continuing this program. If so please explain...
How did you hear about us?
Waiver Of Liability*
I understand that as with all activity, risk is involved in participation in SkatesOut and related activities from minimal to catastrophic, I release SkatesOut, Sparkles Roller Rink, their Officers, Instructors from all responsibility
Skates' Out Classes*
Quantity*
Please enter a value between 0 and 10.
Billing Info
First Name*
Last Name*
Email*
Address*
Address 2
City*
State*
Zip*
Country*
Total
$0.00
Email
Email
This field is for validation purposes and should be left unchanged.

Billing Info