Youth Name *

First Name

Last Name

Birthday *

MM

DD

YYYY

Youth Contact Info: Youth Phone Number

(###)

###

####

Name *

First Name

Last Name

Cell Phone *

(###)

###

####

Name *

First Name

Last Name

Cell Phone *

(###)

###

####

Will your youth need rental equipment? *

Yes

No

Please check any/all rental equipment your youth will need.

Note: Ski Goggles are not available for rent

Skis

Ski Poles

Ski Boots

Snowboard

Snowboard Boots

Helmet (helmets are required to participate)

Skier Ability

1. Entry level, novice, or beginner skier. Skis conservatively, prefers slower speeds and easy/moderate slopes.

2. Intermediate skier. Prefers variety of trails and speeds.

3. Advanced to expert skier. Aggressive skier who prefers to ski at high speeds. Prefers to ski steeper and more challenging terrain. Higher than average release settings.

Check each box *

The use of drugs and/or alcohol is prohibited. If drugs or alcohol are found, the parents will be called to take their youth home.

Participants will not ski alone. Youth will ski with at least one other person at all times.

Inappropriate physical contact is prohibited. Any sexual or violent physical contact will result in parents being called to take the youth home.

Transportation: Transportation on this trip will be in private vehicles driven by youth ministry staff and volunteers. I give permission for the participant to ride in private vehicles and agree to release and hold St. Michael's harmless from any claims or demands, for any injuries or damages arising from said transportation.

Medical Release: In case of emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give permission to hospitalize and/or secure proper treatment for the participant.

Release: I hereby release St. Michael's from any and all claims or demands, for injuries/damages arising out of the acts or omissions of the independent contractors employed by St. Michael's, the acts of other participants/strangers, and the acts or omissions of St. Michael's .

Photographs: Any photograph or audio or video recording of the participant may be used in future materials by St. Michael's and/or posted on the website, communications, or social media.

Indemnification: In the event that the participant is a minor, the parent/guardian agrees to hereby indemnify and hold harmless St. Michael's from any claim covered by this agreement and hereby agree to reimburse St. Michael's for any and all expenses that may be incurred in connection with the assertion of such claim, by or on behalf of a participant or parent/guardian, including court costs and reasonable attorney fees.

Changes: St. Michael's reserves the right to amend any program for operational reasons and/or in the best interest of the participants safety and convenience. St. Michael's reserves the right to cancel the program prior to departure. In this case, all costs would be refunded.

Consent: The parent/guardian gives their permission and consent to participate in the program. They agree and acknowledge that submission of this form binds them to the terms of this agreement. They acknowledge that they have read the terms of this Release and Agreement.