Membership Application

The RRVFSC values its members and appreciates your application for membership.

As a new member you are required to download, read and sign the SafeSport Statement, Waiver and Release of Liability Form, Skater Code of Conduct, Parent Code of Conduct Form and Media Consent. Please download, sign and mail all FIVE of these forms to: RRVFSC, PO Box 2901, Fargo, ND 58108.

Renewing members are required to indicate their agreement by clicking the "I agree" checkbox in the membership level area.

Also by clicking the "I agree" checkbox in the membership level area I am going to volunteer three (3) shifts to the Classic being held February 9-11, 2024. If I do not wish to volunteer I will buy my way out with a check payable to RRVFSC for $300.00. Checks can be mailed to Box 2901, Fargo ND 58108. I understand I will be billed for any shifts signed up for but not fulfilled at the rate of $100.00 per shift.

First & Last Name *

Address *

City, State, Zip *

Date of Birth *

Home Phone # *

Other Phone #

Email Address *

USFS# *

School *

2023-24 Grade *

U. S. Citizen? *

Yes

Membership Levels - Select One

I am a *

Introductory Member - $50--I agree to fulfill the mandatory volunteer hours. I will sign and send required forms to the Club

Additional Family Member - $47- I agree to fulfill the mandatory volunteer hours. I will sign and send required forms to the Club

New or Renewing Member - $85.00 - I have reviewed the Skater Code of Conduct, Parent Code of Conduct, Media Consent, SafeSport Statement and Waiver and Release of Liability. I will also fulfill the mandatory volunteer hours.

Associate Member - $85.00 - I have reviewed the Skater Code of Conduct, Parent Code of Conduct, Media Consent, SafeSport Statement and Waiver and Release of Liability.

4 year Collegiate Member - $110.00 - I have reviewed the Skater Code of Conduct, Parent Code of Conduct, Media Consent, SafeSport Statement and Waiver and Release of Liability

PARENTAL 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 Red River Valley Figure Skating Club and the facility the activities are taking place in and their staff and to members of the Red River Valley 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.

Name of Minor Child Member *

Name of Parent/Guardian *

Initials of Parent/Guardian *

This consent for Medical Attention shall be binding and effective for the 2023-2024 membership year of Red River Valley Figure Skating Club.

Emergency Contact Person *

Phone # *

Name of Insurance Company *

Policy Holder *

Policy # *

My initials below indicate that I agree to the Safe Sport Statement, Waiver and Release of Liability, Skater Code of Conduct, Parent Code of Conduct and Media Consent.
*