One Miler Registration

February 26, 2017

Yes, I want to register for the DFSC's Winter One Mile *

Select to Register ($15)

First Name *

Last Name *

Age *

School *

Paren/Guardian - First/Last Name *

Parent/Guardian Email Address *

Street Address *

City *

State *

Zip Code *

Phone Number *

Cell Phone

Parent Verification

Checking this box and
submission of this form
indicates that I am the
parent/guardian of any
skaters listed that are
not 18 yrs old or older.
*

I am the parent or legal guardian of the above named skater(s)

Tee Shirts

Event Tee Shirts may be pre purchased for $15 each. They are available in youth sizes small - extra large. Adult Tee Shirts are available in the sames sizes. Indicate in the appropriate box(es) below the quanity of the size(s) you would like to order.

Youth Sizes

	Small
	Medium
	Large
	Extra Large

Adult Sizes

	Small
	Medium
	Large
	Extra Large

Website Permissions

I hereby authorize the Duluth Figure Skating Club (DFSC) to display skating related photographs of the skater named above and to provide skating related information about the skater named above on the DFSC website.

Check the appropriate box to indicate your consent of the Website Permissions *

I agree

I disagree

Credit Card Information

Our orders are processed by PayPal. Once your form has been submitted you will be forwarded to PayPal where you will then enter in your payment information.