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TEAM LYON Registration Form Fill in all the information Below: |
| Student's Name: First Like to be Called:
Last:
Address:City, State: Zip: Male: Female: Birthdate: Grade: Phone: (Home) (Work) (Emergency) E-Mail: Important Medical Information: Medical Insurance Co. & Number: USSA Membership # I ordered an Adventure Pass |
| Entry
Program (no training Dec 24/25, 31 Jan 1) |
| One Day Lessons on Saturdays...........$525.00 |
Paid $ |
Balance $ |
| One Day Lessons on Sundays.............$525.00 | Paid $ | Balance $ |
| Two Day on Saturdays & Sundays.......$690.00 | Paid $ | Balance $ |
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Mighty Mite (no training Dec 24/25, 31 Jan 1) |
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| Full Season: Dec 3rd/4th to March 31st/April 1st | ||
| Two Day on Saturdays & Sundays......$1075.00 |
Paid $ |
Balance $ |
| One Day Lessons Sat Sun........$840.00 | Paid $ | Balance $ |
| Short Season: Dec 3rd/4th to Feb 25th/26th | ||
| Two Day on Saturdays & Sundays........$910.00 | Paid $ | Balance $ |
| One Day Lessons Sat Sun........$745.00 | Paid $ | Balance $ |
| Junior Program (no training Dec 24/25, 31 Jan 1) |
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| Two Day on Saturdays & Sundays.........$1180.00 | Paid $ | Balance $ |
| Mid-Week Program (no training Dec 24/25, 31 Jan 1) |
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| One Day Lessons on Thursday.................$200.00 | Paid $ | Balance $ |
| One Day Lessons on Friday.....................$200.00 | Paid $ | Balance $ |
| Two Day Lessons on Thursday & Friday....$250.00 | Paid $ | Balance $ |
| Extra Race Days: x $50.00 per day | Paid $ | Balance $ |
| Payment Method:Card Number: Expiration Date: Amount:Name on Card: |
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Print this page to your printer and send with payment and a signed "Release Form" to: |
TEAM LYON Alpine Race
Club |
Questions? |