Robby Glantz International Power Skating

We appreciate your interest in Robby Glantz Int'l Hockey...
To help you register, we have provided several options to assist you:

1. Simply fill in the Secure Form below and submit it when completed... OR:
2. Print our PDF Form to register by mail or fax at a later time... OR:
3. Phone in your enrollment by calling 1-800-54-SKATE.

(For payment details click on the Registration Info Button above)

I am enrolling a Hockey Player for the following Program:
(Note: Please use the Tab Key to progress to the next field)
(* = Indicates Important Field)

Program:	#763
Program Location:	Kent (Seattle/Tacoma Area) • 4-Session Power Skating, Puck Protection & Power Moves Clinic • 2018
* Program Age Group Letter:	(If unsure, hit "Back" button to find the correct Group Letter for the Program you are signing up for)
* Attended with us before?:	(Any Robby Glantz Program)
* First Name:	(Preferred first name for helmet sticker)
* Last Name:
* Birthdate:	(MM/DD/YYYY)
Age:
* Street Address:
* City:
* State/Province:
* Zip/Postal Code:
* Country:
Parent's Name(s):
* Mom's Cell:	(i.e.: 818-555-5555)
* Dad's Cell:	(i.e.: 818-555-5555)
Home Phone:	(i.e.: 818-555-5555)
* Full Email Address:
Level of Play:
Division:
Will you help promote our program? If yes, please send:	(# of brochures to distribute to friends, teammates, rinks, etc., in my area)
Hockey Association:
Hockey Assoc. Website:	(if applicable)
Please select your Payment Option
We accept the following:
Payment Option :
Payment Discount:
Discount Group Name: We offer Group Discounts, contact us for the details!	(if applicable) • Group Discounts: A group list MUST be mailed, faxed, or e-mailed to our office before or with the registrations. • Limit of One (1) Discount per player, per camp. • Discounts cannot be combined.
Tuition:	$225
Amount to Charge:	(Amount to Charge after Discount taken, if applicable)
Full Amount or Deposit:
Credit Card Number:
Expiration Date:	MM/YY (i.e. 03/09 for March, 2009)
Name On Card:
Is Credit Card Billing Address the same as the Address above?	If Yes, skip this part and click the Submit Button... If No, please provide the Billing Address Info Below:
Billing Street Address:
Billing Zip/Postal Code:
	Please hit the Submit Button send form to us... To Sign-Up siblings, other skaters, etc. please hit the Locations Button or Back Button... and go through the process again for each skater. Thanks for registering and we'll see you at the rink!!!
To Pay a Balance Due ONLY, please click here