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2020-2021 Manitowoc County Figure Skating Club
Membership and Session 1 Registration Packet
* Pages 4 - 9 will need to be turned in by September 21st!
Club members may sign up on the website or send forms and check to:
**Do not mail to Ice Center/Expo** MCFSC
PO Box 357
Manitowoc, WI 54221-0357
Page 1 – Introduction Page Get Ready for Ice
Page 2 – Club Membership Information
Page 3 – Club Ice Schedule
Page 4 – Club Registration Form
Page 5 – Club Skater Emergency Form
Page 6 – Parental Consent and Consent for Medical Treatment Form
Page 7 – Read and sign COVID Rink Guidelines
Page 8 – Voluntary Waiver and Release of Liability - Covid-19
Page 9 – Club Session 1 Ice Contract
Getting Ready for Club Ice
• MCFSC Membership is needed in order to sign-up for Club Ice.
• There is a COVID release form on membership that must be turned in and signed.
• Skaters will need all forms completed and turned in by September 21st.
No same day registration!
• Skaters will need to wear a mask. They must have gloves or mittens.
• Skaters will be allowed in the ice center 10 minutes ahead of their class time.
• Skaters will need to leave 5 minutes after their ice time is over. If doing back to back
Club Ice skater will remain on the ice.
• Skaters need to come ready to skate. There will be no locker rooms for anyone.
• Maximum for Session 1 is 15 skaters per club ice.
Club Ice start
Sunday, September 27th
Tuesday, September 29th
Wednesday, September 30th
Saturday, October 3rd
1Club Membership Information
Membership: Membership dues, 20 volunteer hours & 2 fundraisers
• Full Membership- $110 Parent & skater
• Additional family members- $40 per person
• Adult Membership/Coach Membership (18 & older)- $80
• Collegiate Member* $80 4-year membership must be a full-time college student
*Skater is required to do 6 hours of volunteer and 1 fundraiser each year
MCFSC Volunteer Hours: 20 hours per family (even if public skate is delayed)
• 2 Public Skates (2 people per public skate or 1 person 4 times)
Any public skate not fulfilled will be billed to the family at $50 per public skate
• The rest of the volunteer hours - can be signed up on-line/on the bulletin board.
• LTS classes count for volunteer hours ½ hr per class.
Any volunteer hours that are not completed will be billed to the family at $20 per hour
1/2 must be completed by 12/31/2020
MCFSC Fundraisers:
• Dip Fundraiser 20 packets of dips or $50 buyout November
• 2021 Skate-A-Thon $100 minimum per family January 2021
Benefits of Joining Manitowoc County Figure Skating Club include:
• U.S. Figure Skating Membership July 1st- June 30th
• Subscription to U.S. Figure Skating Magazine “Skating”
• Skater can test and compete at USFS test sessions and competitions
2020-2021 Important Dates to Remember
• September 27 Club will begin(tentative)
• December 13 Exhibition(tentative)
• January 8-10, 2021 Fox Cities (tentative)
• Skate- A-Thon January 16, 2021 (tentative)
• January 28 - January 31, 2021 Badger State
• March 19-21, 2021 Ice show
22020-2021 Club Ice Schedule
Sunday Evenings
4:30-5:15 pm Club Ice- 45 minutes
5:25-6:10 pm Club Ice- 45 minutes
6:10-6:25 pm Resurfacing
6:25-7:10 pm Club Ice- 45 minutes
7:20-8:20 pm Club Ice- 60 minutes (9/27-10/25) - this is only for part of Session 1 and will not be offered the rest of year
Synchro will tentatively start November 1st. Forms will be available October 1st online
Session 1 September 27 October 4, 11, 18 & 25 November 1 6 weeks
Session 2 November 8, 15, 22 & 29 December 6, (No Club 12/13- Exhibition), 20 & 27 7 weeks
Session 3 January 3, 10, 17, 24 & (No Club Ice 1/31) February 7 & 14 6 weeks
Tuesday Evenings
6:20-7:05 pm Club Ice - 45 minutes
7:15-8:00 pm Club Ice - 45 minutes
Session 1 September 29 October 6, 13, 20 & 27 November 3 6 weeks
Session 2 November 10, 17 & 24 December 1, 8, 15, 22 & 29 8 weeks
Session 3 January 5, 12, 19 &26 February 2, 9 & 16 7 weeks
Wednesday Evenings
6:20-7:00 pm Club Ice- 40 minutes
Session 1 September 30 October 7, 14, 21 & 28 November 4 6 weeks
Session 2 November 11, 18 (11/25 No Club Ice) December 2, 9, 16, 23 & 30 7 weeks
Session 3 January 6, 13, 20 & 27 February 3, 10 & 17 7 weeks
Saturday Mornings
6:30 - 7:30 am Club Ice- 60 minutes
7:40 - 8:40 am Club Ice- 60 minutes
No MCFSC Group Numbers
Session 1 October 3, 10, 17, 24 & 31 5 weeks
Session 2 November 7, 14 & 21(11/28 No Club Ice) December 5, 12, 19 & 26 7 weeks
Session 3 January 2, 9, 16 & 23 (No Club Ice 1/30) February 6 & 13 6 weeks
PAYMENT PLANS ARE DUE FOR SESSION 1 BY OCTOBER 31st! Please mail your payment to: MCFSC
No payments will be accepted at the rink! PO BOX 357
Manitowoc, WI 54221-0357
Make-ups -15 maximum on the ice Skaters must have a contract for each session in order to us make-ups.
Skaters must have a contract for each session in order to us make-ups.
Skaters using a 45-minute make-up can make-up on a 60-minute session if they pay $2
Skaters using a 60-minute make-up on a 45-minute make-up but do not receive a credit
Walk-Ons
MCFSC Members 45 minutes = $11 60 minutes = $13
NON-MCFSC Member 45 minutes = $22 60 minutes = $26
but USFSA Member
All skaters must have a MCFSC/USFSA Membership to skate on Club Ice. Skaters must sign a waiver prior to skating.
Like us on Facebook Manitowoc County Figure Skating Club and Learn-To-Skate. If we have a weather cancellation, it will
be posted on our website www.manitowoccountyfsc.org (under news/alerts) and sign-up for alert from website.
Any questions call Chris Pawlowski 920-973-6756
32020-2021 Manitowoc County Figure Skating Club Membership
Family Name: ____________________________________________
Current EMAIL: ____________________________________________
Skater #1
Name: ______________________ Birthday: __________________
Address: ______________________ USFS#: __________________
City/State/Zip: ______________________ FS Level: __________________
Phone #:______________________ Coach: __________________
Parent Names: ______________________ Grade In School: ____________
Parent Cell#: ______________________ School: __________________
Parent Member- if skater is under 18 (need to fill out completely)
Name: ______________________ Birthday: __________________
Address: ______________________ USFS#: __________________
City/State/Zip: ______________________
Cell#: ______________________
Skater #2
Name: ______________________ Birthday: __________________
Address: ______________________ USFS#: __________________
City/State/Zip: ______________________ FS Level: __________________
Phone #:______________________ Coach: __________________
Parent Names: ______________________
Parent Cell#: ______________________
Skater #3
Name: ______________________ Birthday: __________________
Address: ______________________ USFS#: __________________
City/State/Zip: ______________________ FS Level: __________________
Phone #:______________________ Coach: __________________
Parent Names: ______________________
Parent Cell#: ______________________
MCFSC membership
____Full Membership- $110 Parent & skater
____Additional Family Member(s) $40 per person
____Adult Membership/ Coach Membership (18 & older)- $80
____Collegiate Member- $80 -4-year membership for full time college student
and are required to do 6 volunteer hours & 1 fundraiser
____ Total Membership Fees (no payment plans on membership) _____Check # ______Cash
____ 20 Volunteer Hours per family including 2 Public Skates with 2 people or 4 public skates with 1 person
____ 2 Fundraisers per family (Dip fundraiser & Skate-A-Thon)
___ I give permission for my skater to be photographed by MCFSC
__________________________________________________ _______, 2020
MCFSC Club Member Signature or Parent Signature if skater under 18 Date
4Manitowoc County Figure Skating Club
Skater Emergency Form
This form needs to be filled out and turned in with membership forms. Both parents/guardians must sign this
emergency form.
Skater Name: ______________________ Birth Date: _________________
Address: ______________________
City/State/Zip: ______________________ Phone #: __________________
Father Name: ______________________ Father Work#: _______________
Father Cell#: ______________________
Mother Name: ______________________ Mother Work#: _______________
Mother Cell#: ______________________
If a parent cannot be reached - a relative or friend who will assume temporary care of your child
Name: _______________________ Relationship: ______________________
Cell # __________________________
Health Information
Please list any serious illnesses, severe allergies or chronic conditions:
_____________________________________________________________________
Any medication
_____________________________________________________________________
Insurance Information:
Medical Insurance: __________________________ Insurance#: _________________
Dental Insurance: __________________________ Insurance#: _________________
Hospital Preference: _________________________
Doctor: ____________________________________ Phone #: ___________________
Dentist: ____________________________________ Phone #: ___________________
__________________________________________________ _________
Skater if over the age of 18 years old Date
___________________________________________________ __________
Parent/Guardian Signature if skater is under 18 years old Date
5PARENTAL CONSENT AND INDEMNIFICATION AGREEMENT
I , the minor's parent and/or legal guardian, understand the nature of the above referenced activities and the minor's experience and
capabilities and believe the minor to be qualified to participate in such "activity". I hereby release, discharge, covenant not to sue and AGREE
TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees from all liability, claims, demands, losses, or damages on the minor's
account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including negligent
rescue operations, and further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claims against any of the
above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability,
damage, or cost any Releasees may incur as the result of any such claim.
Skater's Name: ______________________________________
Printed Parent/Guardian name of skater under 18 years old: ______________________________________
Signature of Parent/Guardian: ______________________________________
Date: ______________________________________
Consent for Medical Attention or Treatment
I certify that I, the member, or I, the parent/guardian of said participant, give my consent to the
Manitowoc County Figure Skating Club and the facility the activities are taking place in and their staff and to members of the
Manitowoc County Figure Skating Club , their Board of Directors and volunteers to obtain medical care from any licensed
physician, hospital or clinic, including transportation and emergency medical services, for myself/ourselves and/or said participant
for any injury that could arise from participation in these activities.
If Skater is over 18 years old
Skater's Name: Print ________________________________________
Skater's Signature: ________________________________________
Date: ________________________________________
Skater is under 18 years old
Parent(s)/Guardian(s) Names: -Print ________________________________________
Parent(s)/Guardian(s) Signature if skater is under 18 years old: ________________________________________
Date: ________________________________________
This Consent for Medical Attention shall be binding and effective for the 2020 – 2021 membership year of
Manitowoc County Figure Skating Club.
62020-2021 COVID Rink Guidelines until further notice
• All skaters/legal guardian (if skater is under the age of 18) need to complete a waiver before entering the
building.
• Masks are required at all times.
• No spectators or parents in the facility.
- Only the skaters, coaches and approved volunteers should enter the facility. Currently, we ask that all parents
wait outside of the facility.
• All skaters/coaches need to enter the main ice center door, no entrance by anyone by any other door.
- The doors will be clearly marked for designated entry and exit.
• There will be hand sanitizer just inside the front doors.
-All participants and coaches should use it upon entering the rink.
• Skaters may enter the rink 10 minutes before class/ice time.
• Skaters/coaches should arrive ready to go on the ice. There will be chairs in the lobby that will be 6 feet apart.
Please do not move the chairs.
• Skaters are encouraged to have their own skates. If a skater needs help with putting on skates a parent may
come to a designated area, put skates on and then must leave the building.
• Skaters/coaches will have 5 minutes to leave the building once their ice time is done.
-Skaters must be picked up on time.
• At the start of the season, there will be no public skate sessions
• At the start of the season, there will be no concessions.
• Locker Rooms will be closed until further notice.
• Water fountain and bottle filler are closed.
-Skaters will need to bring their own, labeled and may not share water bottles.
• Upstairs viewing area and conference room are closed.
• Restrooms should only be used for urgent use.
• Skaters are not allowed to loiter or explore other parts of the rink.
• Skaters/coaches that do not feel well or are sick must stay home.
• Cleaning will happen during the transition times.
By signing below, it is acknowledged that this form has been received and
understood.
Printed Participant's Name Printed name of parent/guardian of skater of minor participant
Signature of adult participant or parent/guardian of minor participants listed Date
7Voluntary Waiver and Release of Liability - Covid-19
Relying upon the guidelines provided by the United States Figure Skating Association, the United States Rinks
Association, the State of Wisconsin, Manitowoc County and City of Manitowoc, the Manitowoc County Figure
Skating Club, "MCFSC", I the undersigned on my own behalf and on behalf of my minor child or children as
listed here
__________________________________________________________________________________________
___________________expressly understand that MCFSC has put in place enhanced health and safety
measures to reduce the spread of COVID-19. I also understand that MCFSC cannot guarantee that I or my
child(ren) will not become infected with COVID-19. By signing this agreement and visiting and using the
facilities of MCFSC, specifically the Manitowoc County Ice Center, I acknowledge that an inherent risk of
exposure to COVID-19 exists in any public place where people are present. I further acknowledge the
contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or
infected by COVID-19 by participating in skating activities presented by MCFSC at the Manitowoc County Ice
Center. I further understand and expressly acknowledge on my own behalf and on behalf of my child(ren) that
by participating in skating activities of MCFSC and/or being present at the Manitowoc County Ice Center for
any reason, that such exposure to Covid-19 or infection of Covid-19 may occur and result in extreme illness,
permanent disability, and possibly death. I understand that the risk of becoming exposed to or infected by
COVID-19 at and any MCFSC skating activity, meeting or gathering at the Manitowoc County Ice Center may
result from the actions, omissions, or negligence of myself and others, including, but not limited to, MCFSC
and its volunteers, instructors, program participants and their families. I voluntarily agree to assume all of the
foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not
limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind,
that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the
Manitowoc County Ice Center or participation in MCFSC programming (“Claims”). On my behalf, and on behalf
of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless MCFSC, its volunteers,
instructors, agents and representatives, of and from all Claims, including all liabilities, claims, actions,
damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this
release includes any Claims based on the actions, omissions, or negligence of MCFSC, its volunteers,
instructors, agents and representatives, whether a COVID-19 infection occurs before, during, or after
participation in any MCFSC programming at the Manitowoc County Ice Center.
______________________________________________________________________
Signature of adult participant or parent or guardian of minor participants listed above Date
______________________________________________________________________
Printed name of adult participant or parent or guardian of minor participants listed above Date
82020-2021 Session 1 Club Ice Contract
September 27 - November 4, 2020
Skaters must be registered by September 21st... No exceptions!
Skater's Name: ___________________________________ Birth date: _______________________________
Address: ___________________________________ Grade In School: _______________________________
City/Zip ___________________________________ Coach: _______________________________
FS Passed: _______________________________
Moves Passed: _______________________________
Parent Name: ___________________________________ Parent Cell Phone #: _________________________
Sunday Evenings September 27 October 4, 11, 18 & 25 November 1 6 weeks
_____ 4:30-5:15 pm Club Ice- 45 minutes $54.00
_____ 5:25-6:10 pm Club Ice- 45 minutes $54.00
_____ 6:10-6:25 pm Resurfacing
_____ 6:25-7:10 pm Club Ice- 45 minutes $54.00
_____ 7:20-8:20 pm Club Ice- 60 minutes SESSION 1 ONLY Ends October 25th $66.00
Tentative- Synchro will begin November 1st
Tuesday Evenings September 29 October 6, 13, 20 & 27 November 3 6 weeks
_____ 6:20-7:05 pm Club Ice - 45 minutes $54.00
_____ 7:15-8:00 pm Club Ice - 45 minutes $54.00
Wednesday Evenings September 30 October 7, 14, 21 & 28 November 4 6 weeks
_____ 6:20-7:00 pm Club Ice - 40 minutes $48.00
Saturday Mornings October 3, 10, 17, 24 & 31 5 weeks
_____ 6:30-7:30 am Club Ice- 60 minutes $55.00
_____ 7:40-8:40 am Club Ice- 60 minutes $55.00
*No Group Numbers*
Registration forms are due by September 21st. No hand delivery or same day registration. All Skaters need to be
registered by September 21st!
Club Ice will be limited to 15 skaters for Session 1!
MCFSC Club Members can use payment plan. All payment plans need to be paid in full before signing up for the next
session.
_________________ Total Contract Amount
_________________ 2020-2021 MCFSC Membership $110 ____ already paid for MCFSC Membership
**Skater needs to be a MCFSC Club Member. It is $110 per year- please fill out the membership
form and send it with Club Ice Contract
_________________ Total Amount Paid _______Check # or Cash _______
_________________ Payment Plan for Session 1
Session 1 Payment Plan Due October 31st needs to be mailed to PO Box ...No exceptions!
Club members may sign up on the website or send forms and check to:
**Do not mail to Ice Center/Expo** MCFSC
PO Box 357
Manitowoc, WI 54221-0357
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