Ketchikan Coho's Log Rolling Team, Ketchikan, Alaska

If you would prefer fax or mail please download the registration form and fax to 907-247-8562 or mail to PO Box 9112, Ketchikan, AK 99901.
The 2010 registration fee is $100 for 1 child, $75 for each additional sibling and due on the first day of rolling during the registration period. Fees are used for necessary team expenses, coaching, tournaments & awards, travel, and t-shirts. Your registration fee will be refunded if your child decides to drop out after the first two lessons only. Team members may get the opportunity to roll in the actual shows.
Classes are scheduled 2 days a week for 45 minutes beginning the first week of June and ending mid-August with "free roll" days once or twice a week depending on the show schedule for the Great Alaskan Lumberjack Show. We are still trying to find a place to set up a pond so we can roll everyday and we keep looking for someplace that will be accessible to all.

* information required
*Parent/Guardian:		*Contact Phone: Cell:
Address:		City: State: Zip:
Email:	We will not give out your email address without your permission. Notices regarding practice, tournaments, and general information will be sent out via email. If you do not have an email address, please provide a phone/cell contact.
Emergency Contact :		Contact Phone: Cell:
Address:		City: State: Zip:

Child 1 Name:		Age:	DOB:
Nickname:		Years Logrolling:

Child 2 Name:		Age:	DOB:
Nickname:		Years Logrolling:

Child 3 Name:		Age:	DOB:
Nickname:		Years Logrolling:

Child 4 Name:		Age:	DOB:
Nickname:		Years Logrolling:

Adult Log Rolling Class	I am interested in joining the Adult Log Rolling Class.

REGISTRATION To be eligible to log roll, a participant and his/her parent or guardian must completely fill out and properly sign this form attesting that the participant is physically fit for athletic competition and that the parent or guardian consents to such participation. PARTICIPATION CONTRACT I hereby consent to and approve of the above named child participating in the sport of log rolling. I understand the risks associated with participating in any sport and hereby waive, for myself and the above named child, any and all claims, demands and right of action against the Great Alaskan Lumberjack Show, Ketchikan Coho's Log Rolling Team, employees, coaches, and team coordinators for any injury or accident which may occur to the said child as a result of participating in this sport. Initials required PARENTAL CONSENT AND WAIVER* I hereby verify that the above information is true and correct, and that the participant(s) is/are physically fit for athletic competition. I understand that any false information will result in the immediate suspension from the Ketchikan Coho's Log Rolling team. The participant agrees to comply with the rules and regulations Ketchikan Coho's Log Rolling Team, the coaches, team coordinators, and the Great Alaskan Lumberjack Show facility and its employees. Participants will be asked to sign a behavioral contract prior to their first lesson. Initials *required

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