NAME__________________________________USFSA#______________TEST DATE__________
ADDRESS________________________________HOME CLUB___________________
CITY/STATE/ZIP____________________________PHONE______________________NAME OF PAIR/DANCE PARTNER____________________________________USFSA#________
IS HE/SHE AN AMATEUR ___YES___NO PROFESSIONAL___YES___NO
HIGHEST LEVEL OF DANCE TEST COMPLETED BY PARTNER___________________________TBSC Home Club Members ONLY: School_____________________Principal_________________
School Address________________________________City/State/Zip________________________Applicant MUST BE A CURRENT MEMBER OF THE USFSA. Test applications and fees are due
THREE (3) WEEKS PRIOR TO THE POSTED TEST DATE. Late applications will be
accepted at the discretion of the test chair based on time and availability of judges.
NOTE: If an applicant is not a TAMPA BAY SC homeclub member or Individual USFSA member, a letter of permission to test from the skater's home club must be provided with the test application. No test can be taken without this letter.
*NON_TAMPA BAY SC MEMBER TEST FEES ARE 1 1/2 THE NORMAL FEE PLUS A $25 ICE FEECIRCLE OR HIGHLIGHT TEST(S) TO BE TAKEN:
MOVES IN THE FIELD FREE SKATINGDANCE _Standard_Solo_Adult_Master Pre Preliminary $20 Pre Preliminary $20 Preliminary DW CT RB $20 eachPreliminary $25 Preliminary $25 Pre Bronze SD CC FIT $25 eachPre Juvenile $30 Pre Juvenile $30 Bronze HH WW TF $30 eachJuvenile $35 Juvenile $35 Pre Silver 14S EW FT $35 eachIntermediate $40 Intermediate $40 Silver AW T RF $40 eachNovice $40 Novice $40 Pre Gold BL K PD $45 eachJunior $50 Junior $50 Gold VW WW QS AT $50 eachSenior $55 Senior $55 Jr International R SW AUS CON $55 eachAdult Pre Bronze $25 Sr International YP RW TR SAM GW $60 each Adult Bronze $30 Preliminary Pair $25 Adult Silver $40 Preliminary Free Dance $25 Juvenile Pair $30 Adult Gold $50 Bronze Free Dance $35 Intermediate Pair $40 Silver Free Dance $45 Novice Pair $45 Gold Free Dance $55 Junior Pair $50 Senior Pair $60 The applicant and parent/guardian agree per USFSA rules to hold harmless the USFSA, the Tampa Bay Skating Club, Officials of the Tampa Bay Skating Club, and the Tampa Bay Skating Academy, management of the Academy from any and all loss, damage, and/or injury that may be sustained by anyone in any manner while participating in this test session.
Signature of Applicant_____________________________Print Name______________________
(parent/guardian if under 18yrs)Signature of Professional___________________________Print Name______________________
7/23/99