Alpine Ice - Online Enrolment Form

Online Enrolment Form

Please provide the following contact information

Full Name	*
Street Address	*
Address (cont)
City	*
Postcode
Home Phone
Emergency Phone
Fax
Email	*

Age if under 21
Date of Birth
Gender
Specific Skating Interest
Have you Skated before
Kiwi Skate Level achieved
Select the course you prefer
Select the Term
Do you have your own skates

Preferred Method of Payment

	Credit Card - Please present your credit card for payment before the start of classes. Alpine Ice only accepts VISA and MasterCard
	Cheque
	Cash

See Conditions that apply to Alpine Ice Skate School Classes.
CONDITIONS OF ENROLMENT

If under the age of 18, a Parent or Guardian must sign the form.

Payment is to be made prior to commencement of course.

If paying by cheque please add 30c cheque fee and make payable to: Alpine Ice Sports Ltd

You can also print out this form and post with Cheque to:
Alpine Ice Sports Ltd, P.O. Box 7260, Christchurch

Have you read and accepted the enrolment conditions?

Yes

Parent or Guardians Authorisation

Alpine Ice Sports and Entertainment Centre, An International sized Ice Skating and Entertainment facility located at:
495 Brougham Street, Opawa, Christchurch, New Zealand.
Ph: +64 3 366 9183 | Fax: +64 3 379 1706