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Competitive Edge Day Pass Registration Form
Name
(Required)
First
Last
Date of Birth
(Required)
mm
dd
yyyy
Parent Name
First
Last
For applicants under 18
Phone
(Required)
Email
(Required)
Competitive Edge: Last Level Completed
(Required)
- Please Select -
Free Skate 2
Free Skate 3
Free Skate 4
Free Skate 5
Free Skate 6
Pre-Preliminary Skating Skills
Preliminary Skating Skills
Pre-Bronze Skating Skills
Bronze Skating Skills
Pre-Silver Skating Skills
Silver Skating Skills
Pre-Gold Skating Skills
Gold Skating Skills
Does the participant have a consistent axel?
(Required)
Yes
No
Please select your private coach
(Required)
Tatiana Kozmava
Alexey Shumskyi
Andrea Phillips
Chrissy DeDompablo
Jan Kirkley
Justin Childers
Megan Muzy
Melissa McMenemy
Natalie Martin
Randy Trabing
Sierra Venetta
Stephanie Williams
Tina Marie Webb
Mindy Sellers
Other
If your coach is not a Madhatter Coach, please name your coach and rink
Permissions for Photos/Videos
(Required)
Yes, I grant permission
No, I do not grant permission
Do you give permission to the Atlanta Ice House to photograph you or your child for promotional purposes?
Waiver
(Required)
I/We have read and understand and agree to comply with the waiver
Competitive Edge Session
(Required)
February 17
February 24
March 2
March 9
March 16
Total
Credit Card
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Phone
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About
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