Midland Curling Center
2009-2010 Curling League Enrollment
(one person per application form)
Name: _________________________________________________________________
Address: _______________________________________________________________
City/State/Zip: __________________________________________________________
Home Phone: ____________________ Business Phone: ______________________
E-mail Address: __________________________________________________________
Leagues: (check all the leagues you are curling in)
_______ Monday (Open) ________ Thursday Novice ________ Sunday Youth
_______ Tuesday (Women) ________ Friday Mixed ________ Sunday Mixed
_______ Wednesday (Open) _______ Substitute Curling _______ Sunrise League
FEES: **$10 late fee added if paid after Nov 30/09
Registration # Fee ** Total
Novice Curler-Nov/09-Jan/10 17505B $88 __________
Novice Curler-Jan/10-Mar/10 17505D $88 __________
First Season Curler 17500A $170 ___________
Veteran 1 League 17501A $245 ___________
Veteran 2 + Leagues 17502A $370 __________
Junior (student >18yrs) 17504A $120 ___________
Sunday Youth (<18yrs) 17506A $60 ___________
Substitute 17505A $90 ___________
Total Fees $ ____________ A
Membership Dues: Great Lakes Curling Association & USCA
– benefits include playdown eligibility and US Curling News Subscription
Individual 17507A $30 ____________
Couple 17507B $55 ____________
Junior (14 to 21 yrs) 17507C $27 ____________
Youth (13 yrs and under) 17507D $13 ____________
Total Membership Dues $ ____________ B
Total Fees and Dues $ A+B
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Deliver Enrollment Form and Payment to the Midland Community Center