Swiftie Shake it Off Sunday 6/8 2:00-6:00

Solid purple Swift t shirt $15
Limited availability

We will have prize drawings through out the event.

We will have lots of Taylor Merch for sale including disco ball cups, Era cups, posters, blankets, key chains, lanyards, signs, Friendship bracelets, shirts and sweat shirts. Limited to Stock on hand.

Disco Ball cup $3 — Era’s tour cup $6 — 8×10 Eras Poster $6

I Love Taylor LED Baton $3.50 — Celebrate music Painting set $10 — Music Straws $1

Swift Sweat Shirt (size 9-10 youth) $12—Inflatable Microphone $1—Swift Lanyard or Key Ring $1

Registration is not complete until forms are completed and payment is made.

Space is limited to 50

Summer Camp https://rocketskatingplus.com/skating-stem-camp-june-24-28/

Swiftie Shake Off Sunday 2:00-6:00 6/8

Spam protection, skip this field

Swiftie's name & age

Which item do you want to paint?

Disco Ball

Guitar Shelf Sitter

Swiftie Era Sign

Swiftie's name & age #2 (optional)

Which item do you want to paint? Swiftie #2 (optional)

Disco Ball

Guitar Shelf Sitter

Swifty Era Sign

Swiftiet's name & age #3 (optional)

Which item do you want to paint? Swifties #3 (optional)

Disco Ball

Guitar Shelf Sitter

Swifty Era Sign

Parent's names & cell phone numbers

Parent's name & cell phone numbers (optional)

Would you like to be texted about our future events

Emergency Contact Information – Alternate Pickup/Release Name & cell number (optional)

What is your email?

I understand that I will be notified in the case of a medical emergency involving my child. In the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill.

I understand that Rocket Skating Plus LLC it’s owners and it’s employees and volunteers will not be responsible for any medical expenses that may be incurred, but that such expenses will be my responsibility as parent/guardian.

Medical Release Information

Primary Physician & phone #

Hospital Preference

Please list any medical concerns, including any requiring maintenance medication or any condition that may require us to call the paramedics.

Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason?

Is your child allergic to any type of food or medication?

Does your child require a special diet?

The purpose of the above listed information is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. Is there any additional medical information that we may need to be aware of?

Rocket Skating Plus LLC Camp, and its co-organizers are not responsible for lost or damaged personal property. All scheduled events are subject to change.In case of an emergency, and if a family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (i.e. EMT, First Responder, and/or Physician).

Photo Release – I hereby give permission for my child to be photographed during the Rocket Skating Plus Camp. I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Rocket Skating Plus Camp and its affiliates.

Please comment how you will be making your payment. I will text you the link and total due if you want to pay via paypal or venmo. We can do a CC over the phone or you can stop by the rink during open hours. All please note if we will be sending in an invoice to Respite.

Please note any Early Drop off or Late pickups needed. $10 per family, per date, per arrangement.

How did you hear about our event?

Would like a Tshirt $15? If yes, what size?

Add on for the Event

Disco Ball cup $3

Eras Tour Cup $5

Eras Tour Poster $6

Music Straw $1

I Love Taylor Baton $3.50

Celebrate Music Wooden Set $10

Pink Swiftie Sweat Shirt $12

Swiftie Lanyard $1

Swiftie Key Ring $1

Inflatable Microphone $1

N/a

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