Form Center

2. Skater Information
4. Name:*
5. Age:*
6. Skating Level:*
8. Parent/Guardian:*
9. Phone:*
11. Email:*
15. Preferred Instructors & Lesson Times
17. Instructors/Rates

    Check all that apply 

    Listed rates are per 30 minutes 

    *indicates Junior Coach

    
    

    1. Christian Newberry ($45)
    2. Graham Newberry ($45)
    3. Mark Militano ($41)
    4. Jack Newberry ($39)
    5. Harriet Newberry ($39)
    6. Jana Militano ($38)

    1. Anita Saxena ($36)
    2. Ashley Deavers ($35)
    3. Phillip Bagnall ($32.50)
    4. Reilyn Intemann ($20)
    5. Adria Liliac* ($20)
    6. No preference, assign someone
19. Day/Time

    1. Monday AM
    2. Tuesday AM
    3. Wednesday AM
    4. Thursday AM
    5. Friday AM
    6. Saturday AM

    1. Monday PM
    2. Tuesday PM
    3. Wednesday PM
    4. Thursday PM
    5. Friday PM
Leave This Blank:


21. Submit

* indicates a required field