REDWOOD EMPIRE CRYSTALLINE CLASSIC
A Showcase Competition
Redwood Empire Ice Arena
1667 West Steele Lane
Santa Rosa, California 95403
APRIL 12, 13, 14, 1996
ENTRANCE APPLICATION
PLEASE PRINT PRECISELY AND CLEARLY: (ILLEGIBLE AND/OR INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED) (For Pairs and Groups, Please Send Together Separate Applications for Each Skater).
NAME:_______________________________________________________________ AGE_____ M_____ F_____
ADDRESS: __________________________________________________________________________________________
____________________________________________________________________________________________________
PHONE NO.: (_____) ______________ HOME CLUB: ____________________________________ USFSA #_________
PROFESSIONAL: ___________________________________________________ PHONE NO.: (_____) ______________
HIGHEST TEST(S) PASSED: FREESTYLE: ________________________________ PAIRS: _______________________
MOST DIFFICULT JUMP YOU KNOW HOW TO DO: ________________________________________________________
CATEGORIES
(A DOUBLE FEE WILL BE CHARGED FOR LATE ENTRIES, CATEGORY AND/OR SKATING LEVEL CHANGES
* SINGLES: FIRST EVENT $50.00 / ADDITIONAL EVENT: $30.00
LIMITED Preliminary Light ______ (...NO AXELS....) LIMITED Preliminary Dramatic ______
Preliminary Light ______ Preliminary Dramatic ______ Interpretive - Preliminary ______
Juvenile Light ______ (12 YRS & UNDER) Juvenile Dramatic ______ Interpretive - Juvenile ______
Intermediate Light ______ (13 YRS & OVER) Intermediate Dramatic ______ Interpretive - Intermediate ______
Novice Light ______ Novice Dramatic ______ Interpretive - Novice ______
Junior Light ______ Junior Dramatic ______ Interpretive - Junior ______
Senior Light ______ Senior Dramatic ______ Interpretive - Senior ______
Pre Adult Light ______ Pre Adult Dramatic ______
Adult Light ______ Adult Dramatic ______
Masters Light ______ Masters Dramatic ______
Professional Light ______ Professional Dramatic ______
* PAIRS: $80.00 PER PAIR Name of Partner: ______________________________________________________
Novice Pairs ______ Junior Pairs ______ Senior Pairs ______ Adult Pairs ______
* SIMILAR PAIRS: $50.00 PER PAIR Name of Partner: ______________________________________________
* MULTI-GENERATIONAL PAIRS: $50.00 Names & Relation:______________________________________________________________________
______________________________________________________________________________________________________________________________
* GROUPS: $20.00 PER PERSON ($60.00 MINIMUM) ______ How Many in Group __________
NAME OF GROUP: ______________________________________________________________________________________________________________
IF USING A PROP PLEASE READ RULES & RESTRICTIONS ATTACHED
ALSO NOTE STRICT RULES AS TO FEATHERS, BOAS, BALLOONS, COSTUME DECORATION & ANIMALS
ENTRIES MUST BE POSTMARKED BY MARCH 11, 2026
Make check payable to "Santa Rosa FSC" and mail to TERRIE GERSHMAN, 3716 Sacramento Avenue, Santa Rosa, CA 95405.
AMOUNT ENCLOSED: ______________________
ENTRANCE APPLICATION/1996 REDWOOD EMPIRE CRYSTALLINE CLASSIC
CERTIFICATE OF CLUB OFFICIAL
I hereby approve the entry of the registrant and certify that he or she:
1. Is a member of the Club in good standing;
2. To the best of my knowledge is eligible to enter the specified event;
3. Is an amateur in accordance with the rules of the United States Figure Skating Association; and
4. Is following a standard and complete education program in full compliance with the requirements of the registrant's home state.
CLUB OFFICER SIGNATURE ________________________________________________ DATED _______________
TITLE OF OFFICE _____________________________ HOME CLUB OR CITY _____________________________
ONE FORM REQUIRED FOR EACH SKATER
CONSENT OF PARENT OR GUARDIAN
(for Skaters, Under Age of 18 Years)
I am the parent or legal guardian of _________________________________________________________________
I understand that my child/ward will be participating in the 1996 REDWOOD EMPIRE CRYSTALLINE CLASSIC COMPETITION at the Redwood Empire Ice Arena. I understand that the proposed activity can be a dangerous and injurious sport, and that the Arena's officers, management, owners and employees and all members or staff of the United States Figure Skating Association and/or the Santa Rosa Figure Skating Club assume NO responsibility for accidents or injuries to participants or spectators, or loss of property, occurring before, during or after the activity.
I accept full responsibility for ensuring that my child/ward is adequately supervised and controlled while on the Redwood Empire Ice Arena property, and accept responsibility for accidents or injuries to myself, and my child/ward, and for property damage, arising as a result of said activity. I hereby waive all rights to assert or levy any and all claims, losses, liabilities, costs and/or liens against the corporations known as "Redwood Empire Ice Arena, Inc.", and/or "Redwood Empire Ice Operations, Inc.", and the organizations known as "The United States Figure Skating Association" and/or "The Santa Rosa Figure Skating Club" and these corporations' and organizations' officers, management, agents, officials and staff from and against any and all claims, losses, liabilities, costs and/or liens for accidents or injuries to my child/ward, or any other person, or property damage caused by or arising out of his/her participation in the above activity, and occurring before, during or after the activity.
If I am not able to personally supervise and control the activities of my child/ward while on the Redwood Empire Ice Arena property, I agree to provide all necessary medical consents, medical information and emergency numbers to persons of suitable age and discretion who have agreed to supervise and control my child/ward. I have signed the foregoing form in my individual capacity, and on behalf of my child/ward, and his/her heirs, executors and/or administrators.
BY SIGNATURE BELOW I ALSO ACKNOWLEDGE THAT I HAVE READ THE RULES & RESTRICTIONS, SPECIFICALLY RULE I. GENERAL, d., 1 THROUGH 11, & UNDERSTAND THAT TO VIOLATE THOSE RULES/RESTCTIONWILL BE CAUSE FOR MY CHILD TO BE DISQUALIFIED FROM COMPETING IN THIS COMPETITION.
SIGNATURE _____________________________________________________________ DATED _____________
PRINT NAME __________________________________________________ CAPACITY: ___________________
SKATERS OVER AGE 18, PLEASE USE THIS FORM
ASSUMPTION OF RISK AND WAIVER OF LIABILITY
(for Adults, 18 years and over)
Ice skating can be a dangerous and injurious sport. All skaters and spectators assume their own risk of injury. The Arena's officers and management, owners and employees, the United States Figure Skating Association, the competition officials and members of the Santa Rosa Figure Skating Club, assume NO responsibility for accidents or injuries to participants and spectators, or loss of property, occurring before, during or after these competitive programs. Each participant is responsible for accidents or injuries to the participant and to others as a result of the participant's activities.
Skaters and skating parents must understand and accept the full risk and financial responsibility of participation in this competition and waive all rights to assert or levy any and all claims, losses, liabilities, costs and/or liens against the corporation known as "Redwood Empire Ice Operations, Inc.", and the organizations known as "The United States Figure Skating Association" and/or "Santa Rosa Figure Skating Club". Furthermore, the skater must waive the rights of their heirs, executors and/or administrators of their estate to assert or levy any and all claims, losses, liabilities, costs and/or liens against the aforementioned corporations and organizations, officers, management, agents, officials and staff from and against any and all claims, losses, liabilities, costs and/or liens for accidents or injuries to themselves or any other person, or property damage caused by or arising out of their participation in this competition.
BY SIGNATURE BELOW I ALSO ACKNOWLEDGE THAT I HAVE READ THE RULES & RESTRICTIONS, SPECIFICALLY RULE I. GENERAL, d., 1 THROUGH 11, & UNDERSTAND THAT TO VIOLATE THOSE RULES/RESTRICTIONS WILL BE CAUSE FOR MY CHILD TO BE DISQUALIFIED FROM COMPETING IN THIS COMPETITION.
SIGNATURE __________________________________________________ DATED: ________________________
PRINT NAME _______________________________________________________________________________
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