Miss/Ms..........................................................
Mr.Mrs.
ADDRESS..............................................
.....................................................
POSTAL CODE..........................................
PHONE................................................
SKATE CANADA # ......................................
HOME CLUB..................................................
(if not the London Skating Club)
MEMBERSHIP FEES:
GUEST FEE - $ 14.00 (limit 2 Sessions Per Season)
NO REFUNDS
PLEASE COMPLETE THE ABOVE & MAIL WITH A CHEQUE PAYABLE TO:
THE LONDON SKATING CLUB
c/o 1200 RICHMOND STREET
LONDON ONT N6A 3L4
INFO: 519-434-1973 or 519-451-4527
The London Skating Club, Its Employees and Coaches
or the University of Western Ontario shall not be
held responsible for any accident, injury,death
or loss of personal property however caused.



