SOCIAL ICE DANCE FORM

The social ice dance is open to all U.S Figure Skating members and is being hosted by the FSC of Bloomington in conjunction with the 2010 U.S Adult Championships. You are invited to a social ice dance session after the conclusion of the 2010 U.S Adult Championships. This is a great opportunity to meet and enjoy other ice dancers in a fun, noncompetitive atmosphere. Dances of all levels will be played, and special requests will be allowed. U.S Adult Championship competitors, coaches and officials will have priority with advanced registration.

SUNDAY, APRIL 18, 2010
9:00 a.m. - 12:00 p.m.
Bloomington Ice Gardens
$30/person

Skater(s) Name(s)

First Last First Last

Email(s)

Phone - (###) - ### ####

If you wish to make your payment via PAY PAL, please click on Pay Pal icon, complete your payment, return to this form, enter PAY PAL REFERENCE NUMBER in the field below and SUBMIT your entry.

#Skaters - $ TOTAL

You may send check to: Brenda Baga 2917 Southbrook Drive Bloomington, MN 55431. Make checks payable to: Adult Nationals 2010. or use online PAY PAL option. Credit card payments are securely processed via Pay Pal. This form has Pay Pal link with specifically for the event-customized amount of dollars per one entry. However, payer can alter the amount by changing the number of instances to which Pay Pal will adjust the payment amount automatically. Pay Pal link will open in separate Internet browser window, which will allow to complete payment and enter Pay Pal reference ((optional) information into form before its submission. You do not need a Pay Pal account in order to pay via Pay Pal.
When you reach their site you can enter your credit card information on that screen.
If you have a Pay Pal account you can login and make payment.
Click on "Printer Friendly Receipt" and print or save for your records.

Pay Pal Reference#

Checks payable to FSC of Bloomington to:
Brenda Baga
2917 Southbrook Drive
Bloomington, MN 55431

Any questions please direct to president@fscbloomington.org