Yebin Mok Skate Camp Entry Form – Extra Entries 21/9/2025

Skaters Name *

Date of Birth *

DaySelect day12345678910111213141516171819202122232425262728293031

MonthSelect month123456789101112

YearSelect Year212621252124212321222121212021192118211721162115211421132112211121102109210821072106210521042103210221012100209920982097209620952094209320922091209020892088208720862085208420832082208120802079207820772076207520742073207220712070206920682067206620652064206320622061206020592058205720562055205420532052205120502049204820472046204520442043204220412040203920382037203620352034203320322031203020292028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926

Street Address

Address 2

City

ZIP / Postal Code

Email Address *

Phone *

Coaches Name

BRITISH ICE SKATING Level Attained *BRITISH ICE SKATING Level AttainedBeginnerLevel 1Level 2Level 3Level 4 (Basic Novice)Level 5 (Intermediate)Level 6 (Advanced)Level 7 (Junior)Level 8 (Senior)Please note this is the BRITISH ICE SKATING Level attained on the closing date.

Date Level Attained *

Are you a fully paid up member on 9th September 2025? (If you are you receive a 50% discount)No I am NOT a member – Fee £70Yes I am a memeber – Fee £35

GDPR *Yes, I agree with your data handling policy.

I agree / disagree with my photo being taken and used for Whitely Bay social media purposes. *YesNo

Amount DueAmount Due

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