KIWI SKATE ENROLMENT TERM 2 -2011Name...................................................................Age................ Address..................................................................................... Parent/Guardian......................................................................... Contact Phone.........................Email.............................................. Preferred Time Monday 4pm [ ]
Have you been to Kiwi Skate Before? YES/NO What achievement did you attain?........................................ How did you learn about Kiwi Skate? Friend [ ] School [ ] Newspaper [ ]Website [ ]Other...............
Signed ................................................Parent/Guardian
Please return with your $80 payment for this 10 week term to the Dunedin Ice Stadium |
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