Registration Form

ONLINE LOCK-IN REGISTRATION

Break Out Lock-in
Saturday, September 13, 11PM-7AM
Includes all night skating/biking, pizza, drinks, donuts and milk
$27

Pay before September 13 and receive a free skate pass.
Helmets and Waivers Required.

No refunds or credits for any reason including but not limited to injuries.

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YES! I WANT TO REGISTER FOR The Break Out" Lock-In

$27 (plus tax)

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REFUND POLICY

No refunds or credits for any reason including but not limited to injuries.

To register online, fill out this form and submit.

You may also register at the Skatepark.
Helments and Waivers are required (if not already on file).
Helmets are available to rent in our Pro Shop.

FIRST NAME:
LAST NAME:
AGE (min. age 8-17):
EMAIL ADDRESS
HOME NUMBER:
CELL NUMBER:
PAYMENT INFORMATION *REGISTRATION WILL NOT BE PROCESSED UNTIL PAYMENT IS RECEIVED*
Payment Method:
Total Due:
Card Number:
Expiration Date:
Name on Card:
Billing Address:
Billing City/State/Zip:
PARENT INITIALS	By initialing above, I accept terms of registration, including Refund Policy and Waiver Requirements. Registration will not be accepted without initials.