2022-2023 Membership Application

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Please fill out a separate form for multiple skaters. Coaches looking for membership please contact us directly.

Part 1 - Membership Identification

Name of skater *

Skater's USFS number (if renewing)

Skater's date of birth *

YYYY

Last test skater has passed (either learn to skate or USFS) If not sure put unknown and we can look it up *

Select Membership *

Full Club Membership $110 (1skater pre-juvenile and above )

Full Club membership Additional family member $70 (1 skater pre-juvenile and above; must have paid for 1 full club membership)

Full Aspire Membership - $75 (1 skater pre-free skate through preliminary, previous USFS membership)

Introductory Aspire Membership - $45 (1 skater pre-free skate through preliminary, no previous USFS membership)

Transfer Membership $30

Coach membership - $70

Select Payment Method *

Cash/Check (Check made out to Michiana Ice FSC sent to Katie Cousins 15585 Windingbrook Drive Mishawaka, IN)

Credit Card (Note there is a service fee with all credit card transactions, an invoice will be sent if you select this option)

Part 2 - Additional Mandatory Information

Parent/guardian First and Last name *

Address *

City, State, Zip *

Email Address *

Phone Number *

Home Club (if other than Michiana Ice FSC)

Terms of Membership

By submitting this form, members agree to abide by and conduct themselves in a manner consistent with the bylaws, official rules, policies, procedures, code of conduct and principles of ethical behavior of the Michiana Ice Figure Skating Club and U.S. Figure Skating. Completed and signed applications must be submitted with full payment in order to be processed. U.S. Figure Skating membership will not be applied or renewed until forms and payments are complete. *

I agree

Required

Do we have permission to use the participant's picture for promotional purposes in print or digital? *

Yes

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