CATAMOUNT WINTER CLUB

Contact Details

Parent or Guardian's Name*

First Last

Email*

Enter Email Confirm Email

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Name

First Last

Emergency Contact Phone

Pleas make this different than the phone listed above, if possible.

Emergency Contact's Relationship To Club Member

Pick Up Authorization

Please list all adults (including parents) authorized to pick up your club member:

Participant Info

One form submission per club member. For additional members, finish this form, then start a new registration form.

Child's Name*

First Last

Club Members Age & Date of Birth

Example: 10 (9/4/13)

Does your Club Member need any specific physical, mental, or emotional support while at club?

Please share information about your child’s mental, emotional and physical health that will enable us to better serve them. Describe strategies you’ve found effective in addressing this/these need(s). Please include any medications or allergies our staff should be aware of.

Briefly describe your Club Members current xc ski, fat bike, and snowshoe ability and goals for the season.

Cancellation Ploicy*

I understand

Any cancellations or change requests must be made prior to December 1 in order to receive a refund, minus a $50 administrative fee. Any cancellations or requests received from December 1 until 2 weeks to the start of the month your member is registered for will receive a 50% refund. Cancellations made within 2 weeks of the beginning of the month your member is registered for will not be eligible for a refund.

Product Name*

Catamount's Winter Clubs run from January to mid-March.

Monthly Club Registration Options

We have monthly options for you! Please select all the months your club member will participate in this winter

January ($225)

February ($225)

March ($150)

Club Rental

Club Rentals

$50 per month gets your club member access to xc ski, snowshoe, fat bike, and sled rentals for all club dates and timeframes. If you have all your own equipment, please skip this question.

January

February

March

Subtotal

$0.00

Tax

$0.00

Total

Credit Card*

Cardholder Name

Card Details

Contact Details

Participant Info