CITY __________________________________________________ STATE ________ ZIP CODE _____________
PHONE ____________________________ PARENT OR GUARDIAN ___________________________________
E-mail _______________________
**CHECK TYPE OF PASS REQUESTED**
INDIVIDUAL PUBLIC SKATE PASS @ $99 _______ FAMILY PUBLIC SKATE @ $199 _______
YOUTH PUBLIC SKATE (12 and under) @ $89 _______ ADULT SKATE & SHOOT @ $149 _______
LIST ALL FAMILY MEMBERS REGISTERED (Family pass only):
NAME ________________________ NAME ____________________
NAME ________________________ NAME ____________________
NAME ________________________ NAME ____________________
ADDITIONAL SEASON PASS BENEFITS:
** $5 ON SKATE SHARPENING!!
** $1 FOR SKATE RENTAL ($3.00 value)!!
By signing this form you agree that all the above persons with a season pass will adhere to the rules and policies of the Greater Canandaigua Civic Center. You also agree that failure to do so may result in the GCCC revoking a members pass without refund. Passes are not transferable to other persons or session (Ex. – skate and shoot passes are not valid for public skating; public skating passes are not valid for skate and shoot). Passes will be valid from the September opening in 2017 through the April closing date in 2018. No refunds will be given on any season pass for any reason. Make check payable to :GCCC
SIGNATURE ________________________________________________________ DATE ___________________
