Northern Star Skating Institute
APPLICATION
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NAME________________________________________________
ADDRESS_____________________________________________
TOWN_______________________STATE________ ZIP CODE_________
TELEPHONE_____________________________
AGE________ BIRTHDATE_____________________
EMAIL ADDRESS________________________________________
Any learning differences or physical limitations we
should know about ? ________________________________________
_____________________________________________________
PEANUT HOCKEY
Please select session(s)
amount paid
Session I Thursday 3:50-4:50pm Sept.17 – Nov.19, 2009 $175* /10 weeks ______________
Session II Thursday 3:50-4:50pm March 4 – April 15, 2010 $125*/7 weeks ______________
* INCLUDES SHIRT
TOT SKATING
Session I Wednesday 9:30- 10:30 am September 23- November 18, 2009 150.00 ____________
no class 11/11/2009
Session II Wednesday 9:30- 10:30 am December 2,2009- February 3, 2010 150.00 ____________
no class 12/23 or 12/30
Session III Wednesday 9:30- 10:30 am February 24 - April 14, ,2010 150.00 ____________
Each Tot Session is 8 weeks long
**ask about our full season & family discounts**
DROP OFF TO MANAGER IN FRONT OFFICE OF HOBOMOCK ARENAS or
Print and send completed application and payment
to : Northern Star Skating Institute or NSSI
P.O. Box 547
Bryantville, MA 02327