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Skate Ponoka Star Skate Online Registration 2020-2021
Contact Janelle Hinton if you have any difficulties filling out this form.
janellerhinton@gmail.com
Or visit
www.skateponoka.weebly.com
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Skate Ponoka 2021-2022
Welcome to Skate Ponoka's online registration. Please fill out a separate registration form for each skater.
Skater Contact Information
First Name
*
Your answer
Last Name
*
Your answer
Male/Female
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Your answer
Birthday Year/Month/Day
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Your answer
Cell Phone Number (if skater has a cell phone) Please type N/A if not applicable
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Your answer
Parent/ Guardian Information
Parent or Guardian Last Name
*
Your answer
Parent or Guardian First Name
*
Your answer
Home Phone Number
*
Your answer
Cell Phone Number
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Your answer
Email
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Your answer
Address
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Your answer
Town
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Your answer
Postal Code
*
Your answer
Secondary Contact
*
Your answer
Home Phone Number
*
Your answer
Cell Phone Number
*
Your answer
Emergency Contact
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Your answer
Home Phone
*
Your answer
Family Dr.
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Your answer
Do they have an medical conditions?
*
Your answer
Does your family reside in the Town of Ponoka or County of Ponoka?
*
Town of Ponoka
County of Ponoka
Other
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