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2. First Name*
3. Last Name*
5. Students first name
6. Students Last Name
8. Age of Student*
10. Phone Number*
12. Email*
14. Skating Experience*
    -- Select One --Beginner, never taken a lesson beforeStudent can get across the ice without falling or assistanceStudent can skate backwardsStudent is looking to fine tune their skillsStudent is advanced and looking to take their skating to the next level!

    How would you describe students skating experience?
16. Goals*
    -- Select One --HockeyFigure

    Are you looking to progress is figure skating or hockey?
18. What happens next?
    We will submit your information to our instructors. Please note that instructors are all independent contractors and may or may not have availability to take on additional students. If an instructor is available, they will reach out to you to discuss a potential lesson.
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

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