2015-2016 Diamond City Figure Skating
Club Membership Form
Membership Name: _________________________________________________________________________________
New Member? Yes
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Membership Renewal- USFS #: __________________________
OR
Street ______________________________________ City _______________________ State ________ Zip ________
Phone #: __________________ Cell: ____________________Email Address: _______________________________________
Important: We communicate the majority of club news by email. Email is sent using a secure system.
Age ____ Birthdate: __ I __ I__ Male
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Female
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Primary Activity within Club: Board Member/ Coach/ Competitive Skater/ Parent or Legal Guardian/ Recreational Skater
Currently a teaching professional?: No
☐ OR Yes-PSA#: ______________________ _
What is the Highest Applicable Test Level you have passed as of the date of this application?
Basic ______________________Freestyle __________________ Moves In the Field __________________________
PARENT/GUARDIAN INFORMATION
(Please complete if you are the parent or guardian of a skating member under the age of 18 mentioned above.)
Parent I Guardian Name: ________________________________________________________________________
Street ______________________________________ City _______________________ State ________ Zip __________
Phone #: ______________________ Cell: _________________________ Email Address: ______________________________
Important: We communicate the majority of club news by email. Email is sent using a secure system.
VOLUNTEERING
Skating clubs are run by volunteers and at DCFSC we encourage and value volunteerism by all our members,
including our skaters under the age of 18. If possible, take the time to volunteer with us. You will learn more about
skating and make new skating friends. Please let us know if you are interest in helping in any of the following areas:
Special Events
Marketing
☐ Fundraising ☐ Competitions ☐ Ice Payment Monitor ☐ Printing ☐
☐ Sponsorship Drive ☐ Other: ______________________________________________ Thank You!
MEMBERSHIPS (please check level)
Introductory Member
First Family Member
Second Family Member
Third + Family Member
Coach Level
Associate Level
$60.00
$75.00
$35.00
$30.00
$55.00
$45.00
Collegiate Level
Patron Level
$75.00
$60.00
Total Membership Fee: $ __________________ _
$15.00 LATE FEE FOR RENEWAL IF RECEIVED AFTER JUNE 30.2015
The Diamond City FSC is a not-for-profit 501 (c) (3)
organization. Your donations are graciously appreciated
and support the activities of the club in many ways.
Total Donation Enclosed: _________________________
DCFSC Membership Levels and Membership Fees 2015-16 Season
Introductory Level – A new member whom has never held a USFSA or basic skills membership. $60
First Family Member- For one skater/parent/guardian. (If more than one member in household, a skater is always
listed as first family member.) $75
Second Family Member- For one subsequent household member. $35
Third (and further) Family Member- For one subsequent household member after first and second are paid. $30
Coach Level- Certified, Insured coaches who wish to participate in and support DCFSC events. $55
Associate Level- Any person that DCFSC is not your home club but you like to have DCFSC privileges. $45
Collegiate Level- Any full time undergraduate college student who wishes to continue their DCFSC membership
through their collegiate years. It includes membership for 4 years as long as they stay full time and have been a
DCFSC member for at least 4 consecutive years in good standings. $75
Patron Level- Anyone who would like to just support the club (not eligible for a board position). $60
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Late fees will be applied after June 30, 2015.
Please note that all members/skating families are required to participate in one mandatory fundraiser per season.