Londonderry Recreation Ski Club Program Chaperone Registration Form (Please Print Clearly and Legibly)

Transcription

1 Londonderry Recreation Ski Club Program 2014 Chaperone Registration Form (Please Print Clearly and Legibly) Name Phone/Cell Address Children Grade Level Circle Program: A B C Cost: Program A Lift Tickets/Lessons Program B Lift Tickets/Lesson//Ski Rentals $ Program B Lift Tickets/Lessons/Snowboard Rentals $ Check # Total: I would like to be: Full Time Bus Chaperone Alternate Bus Chaperone Car Driver (Not Guaranteed) Dates able to attend: All? Only the Following (circle): 1/11,1/18,1/25,2/2,2/9 Emergency Release Information Health Insurance Co. Group # Policy # In Case of Emergency, Notify: Name Relationship Home Address Phone/Cell # Is there any illness for which you are currently receiving treatment and or medications? Please Explain and List Medications: I have read and understand the Londonderry Ski Club Rules and Guidelines and will adhere to them. In case of Medical Emergency, I hereby authorize any licensed physician, hospital, clinic, or other medical facility to hospitalize and secure proper treatment for myself if I am unable to do so physically. I assume all risks and hazards incidental to participation in the Ski Club including transportation to and from said activities. I do hereby waive, release, absolve, indemnify, and agree to hold harmless Londonderry Ski Club for any claim arising out of injury to me whether the results of negligence or other causes. Signed Chaperone Date:

2 Complete only if renting equipment RENTAL WAIVER & AGREEMENT Complete only if renting equipment Student Name: Age: Parent/Guardian Name (If under 18) Address: City: State: Zip: Phone #: Indicate which of the following services apply for this student: Ski Rental Snowboard Rental Address: Withdrawal policy... A prorated refund will be offered to participants withdrawing from the program only in the event of a proven injury or illness. Please check one of the following SKIER TYPES *:(Only for those renting skis) Type I Skiers: Cautious skiing at lower visual indicator settings, prefer slow to moderate speeds, prefer gentle to moderate terrain, receive lower than average visual indicator settings. This may increase the risk of inadvertent binding release in order to increase the likelihood of release in a fall. Type I settings apply to Ientry-level skiers uncertain of their classification. Type II Skiers: Moderate skiing at average visual indicator settings, prefer a variety speeds. Prefer varied terrain. Type 2 skiers are skiers who do not meet all the descriptions of Type I or Type 3 skier types. Type III Skiers: Aggressive skiing at higher visual indicator settings, prefer fast speeds. Prefer steep terrain. Receive higher than average visual indicator settings. This may reduce the likelihood of release in a fall in order to decrease the risk of inadvertent binding release. Type I- Skiers: For skiers who desire visual indicator settings lower than settings for a Type I skier. Type III+ Skiers: For skiers who desire visual indicator settings higher than settings for a Type 3 skier. PLEASE COMPLETE THE FOLLOWING: Rental Choice Shoe Size Height Weight Stance (Foot Forward) (Left) Regular / Goofy (Right) Skis Snowboard Male or Female * SKIER TYPE Helmet (optional) S, M, L, XL ($4/wk additional) EQUIPMENT RENTAL & LIABILITY RELEASE AGREEMENT: I agree on behalf of myself or on behalf of the minor user I am representing to accept for use AS IS all equipment to be provided during the multi-week program, and I agree to accept full financial responsibility for the care of the equipment while it is in the user s possession. I will be responsible for the replacement at full value of any equipment provided under this form, but not returned to the shop. I agree all rental equipment will be returned by the agreed date. I agree that either I, or an authorized designee, will execute the verification on the Rental Data form for each session. All user information I provide will be true and correct. I understand that the binding system cannot guarantee the user s safety. In downhill skiing, the binding system will not release at all times or under all circumstances where release may prevent injury or death, nor is it possible to predict every situation in which it will release. In snowboarding, skiboarding, and telemark skiing (collectively RECREATIONAL SNOW SPORTS), the binding systems will not ordinarily release during use; these bindings are not designed to release as a result of forces generated during ordinary operation. I understand that the sport of skiing, snowboarding, and other RECREATIONAL SNOWSPORTS involve inherent and other risks of INJURY and DEATH. I voluntarily agree to expressly assume all risks of injury or death that may result from skiing/snowboarding use, participation in this multi-week program, or which relate in any way to the use of the equipment to be issued to the user. I understand that a helmet designed for RECREATIONAL SNOW SPORTS use will help reduce the risk of some types of injuries to the user at slower speeds. I recognize that serious injury or death can result from both low and high energy impacts, even when a helmet is worn. I AGREE TO RELEASE AND HOLD HARMLESS the Gunstock ski/snowboard shop, its owners, affiliates, agents, officers, directors, and the manufacturers and distributors of the equipment and their successors in interest (collectively PROVIDERS) from all liability for injury, death, property loss and damage which results from the equipment users participation in the sport of skiing/snowboarding, participation in this multi-week program, or is in any way related to the use of the equipment, including all liability that results from the NEGLIGENCE OF PROVIDERS, or any other person or cause. I further agree to defend and indemnify PROVIDERS for any loss or damage, including any that results from claims or lawsuits for personal injury, death, and property loss and damage related in any way to the use of the equipment or participation in this multi-week program. This agreement is governed by the applicable law of this state or province. If any provision of this agreement is determined to be unenforceable, all other provisions shall be given full force and effect. I, THE UNDERSIGNED, HAVE READ THIS ENTIRE AGREEMENT, AND FULLY UNDERSTAND THIS EQUIPMENT RENTAL & LIABILITY RELEASE AGREEMENT. Users Signature: Date: Parent/Guardian: If equipment user is a minor, I verify that I have the authority to enter into this agreement on behalf of the equipment user and I agree to be bound by all terms and conditions of this agreement. Parent/Authorized Designee (if under 18) : Date: Emergency Phone Numbers: (Home): (Work):

3 SCHOOL NAME: OUTREACH PARTICIPANT WAIVER PRINT NAME: PHONE: AGE: STREET: CITY: STATE: ZIP CODE: RELEASE OF LIABILITY*** PLEASE READ CAREFULLY*** WARNING: All forms of skiing, snowboarding, recreational activities and the use of aerial and surface lifts are hazardous. Falls and injuries are a common occurrence. Recreational users of the ski area must use deliberate and conscious control and proper equipment, both on the ground and in the air, in relation to ever changing variables and dangers. Safety is directly affected by personal judgment in the severe elements of mountain forest terrain. Ski and/or ride within one s own ability. Be alert to continually changing weather, visibility and surface conditions and other inherent risks including but not limited to: existing and changing surface or sub-surface snow and ice conditions, dirt, grass, bare spots, forest growth, trees, rocks, stumps, and other natural objects and collisions with or falls resulting from such natural objects, lift towers and components thereof, lights, signs, posts, fences, mazes or enclosures, hydrants, water or air pipes (all the foregoing whether above or below the snow surface), snowmaking and snow grooming equipment, marked or lighted trail maintenance vehicles and snowmobiles, other man-made structures or objects and their components, and collisions with or falls resulting from such man-made objects; variations in steepness or terrain, whether natural or as a result of slope design; snowmaking or snow grooming operations, including but not limited to ski jumps, roads and catwalks or other man-made or natural terrain modifications and features including Freestyle Terrain; the presence of and collisions with other skiers and riders and the failure of others to ski and ride safely, in control or within their own ability. I, the undersigned, hereby express my desire and approval for myself or my child s participation in the Learning Center Program. I acknowledge that such participation will include, without limitation, participation in various types of snowsports instruction and activities and the use of Gunstock equipment, as well as the slopes, trails, Freestyle Terrain and related facilities, including ski lifts. I further acknowledge that participation in the program is voluntary and entirely at my risk and/or that of my child. I understand that recreational and other activities involve inherent and other risks of INJURY and DEATH. I agree that having a resort employee present does not lessen the amount or severity of the risks or hazards of these activities. I acknowledge that my child s involvement may include skiing, snowboarding, the use of Freestyle Terrain, lifts and participation in other recreational activities, and that these activities are HAZARDOUS and myself or my child have made a voluntary choice to participate in these activities despite the risks. I hereby promise not to bring a claim against or sue, and AGREE TO RELEASE Gunstock Area, Gunstock Area Commission, the County of Belknap, their shops, employees, owners, affiliates, agents, landowners, officers, directors, and their successors in interest, any equipment manufacturers and distributors, (collectively Releasees ), from all liability for injury, death, property loss and/ or damage that results from participation in recreational activities, that is in any way related to participation in the Learning Ctr. Program, the use of the equipment, or is related to any other activity at Gunstock including all liability that results from the NEGLIGENCE OF Releasees, or any other person or cause. I further agree to DEFEND, INDEMNIFY and HOLD HARMLESS Releasees for any loss or damage arising from claims or lawsuits related in any way to myself or my child s participation in the program, use of the equipment, or any other activities on Releasees premises. I understand that permission to use Releasees premises, and myself or my child s involvement in this program is being given in exchange for the execution of this Release of Liability. I authorize Releasees to administer first aid as they deem necessary. I authorize transportation to a medical facility, at my expense, if deemed necessary by Releasees. Further, in the case of serious illness or injury, if I cannot be reached, I give permission for treatment, including medical and/or surgical care necessary for the well-being of myself or my child, at my expense. I agree that upon transporting my child, to any medical facility, clinic or hospital, that the responsibility of the Releasees shall be totally fulfilled and the Releasees shall have no further responsibility. I understand that Releasees will, to the best of their ability, attempt to notify me as soon as possible in the event of an emergency. I hereby grant exclusive permission to Releasees and their respective agents, clients and assigns to use myself or my child s name and image(s) for the purpose of publicity, public relations, editorial, or other advertising purposes without restriction as to frequency or duration. I acknowledge that this agreement is governed by the applicable laws of the State of New Hampshire. I further agree that any action involving parties or issues relating to or arising out of this agreement must be instituted and prosecuted in the state or Federal courts of New Hampshire. If any provision of this agreement is determined to be unenforceable, all other provisions shall be given full force and effect. I HAVE CAREFULLY READ, UNDERSTAND, AND VOLUNTARILY AGREE TO THIS ACKNOWLEDGEMENT AND RELEASE OF LIABILITY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND AN AGREEMENT BETWEEN MYSELF AND THE RELEASEES THAT LIMITS MY, OR MY CHILD S LEGAL RIGHTS AND I SIGN IT OF MY OWN FREE WILL. As parent/guardian of the above-named minor, I acknowledge that I am authorized to sign this agreement. I acknowledge and agree that I have read the foregoing release and that by signing this release I agree to be bound by its terms. I specifically agree to INDEMNIFY, DEFEND AND HOLD HARMLESS Releasees as defined on this form for any claim, suit, expense or loss which arises out of the above-named minors participation in the Children s Program, or which arise out of the minor s presence on the Releasees premises. DATE: SIGNATURE OF PARENT/GUARDIAN Skier or Snowboarder (CIRCLE ONE) SKI OR SNOWBOARD ABILITY LEVELS: (PLEASE CHECK APPROPRIATE LEVEL) MOUNTAIN MAGIC Appropriate for First time skiers and riders only. MOUNTAIN ADVENTURE Appropriate for guests who have been on snow before UP THROUGH those comfortable on Green Circle (easiest) or Blue Square (more difficult) terrain. MOUNTAIN EXCITEMENT Appropriate for guests who are comfortable on Blue Square (more difficult) or Black Diamond (most difficult) terrain in most conditions. SICK TRICK For extremely advanced skier/boarders

4 2014 Ski Club Chaperone Responsibilities Dates: 1/11,1/18,1/25,2/2,2/9 On the bus list, your group is everyone with the same number as yours, i.e. #13 means Bus 1, Group 3. Prior to Season: Chaperones must call each parent (not child) and review the following: This is REQUIRED for all families, not just new ones. Give them your name and contact numbers, including , and bus number and dates we are going. Remind them of no drop off before 630 am Sundays and 145pm on Saturday at Park and Ride Kids may not board bus until chaperones are present and have current list for check-in. Kids must present a photo I.D. or have a parent vouch for their child. No exceptions! Kids may bring food and drinks on bus, should have a watch, and about $10 for food purchases. Kids should know how to put on/take off own equipment and CARRY their own equipment. ALL EQUIPMENT, INCLUDING GEAR BAGS/BACKPACKS SHOULD BE LABELED WITH THEIR NAMES. Helmets required for participants 18 and under. 1 st offense caught w/out= suspension. Ask parents to speak to their child about free equipment check-in and basket rentals for gear. Remind parents that only they can report absences, not their child. Failure to report absences will be considered a no-show and may be subject to suspension from the program. Special situations, such as a child getting a ride up or home, must be reported to the chaperone. Instructions for these situations are covered later. Ask parents to give you and their child emergency numbers if they won t be home that night. Parents need to be at the Park & Ride for pickups by 430pm on Sundays and 1015pm Saturdays. Ask them not to park in the bus loading zones. Parents need to be aware that kids have free run of the mountain. Even though we are all over the mountain, it is extremely dangerous to ski/board alone. Highly recommend that they ski with a buddy. Tell parents that Ski Club is only cancelled if Gunstock or State roads are closed. We do go when it is snowing. During the week: Only parents may call their child in absent. Do not accept calls from kids. Chaperones must feed this information to their Lead. Chaperones must feed information to their Lead about kids getting rides up and/or home. The Lead must notify Maria or Mark about these.

5 Loading buses in Londonderry: Chaperones need to be at the Park & Ride 6:30am (Sun), and 145pm Saturdays. You must notify your lead chaperone if you are going to be late. No kids are allowed on bus until chaperone is present, have current week s list, and has verified I.D. Check names off as kid s board the bus. You must be accurate with your head counts. All equipment goes under the bus. No ski boots or board boots with bindings allowed on bus. Head count before we leave do a physical head count and verify with numbers on list. Do not count kids getting rides up in car. On Bus: Chaperones should introduce themselves to their kids. Kids need to be seated and facing forward. No kneeling and facing backwards. Lead chaperone should go over rules with kids and remind them of free check-in. On the first night, chaperones should review with kids which lesson level they are signed up for. Remind them that lessons begin at 11a.m. Sundays and 530pm Saturdays at the lesson flags. They are located at bottom of the mountain. Collect trash just before arriving at Gunstock. Remind kids that chaperones will be wearing orange armbands and they can approach any one of us for assistance. Remind kids they need to head for the buses at 3pm Sundays, and 830pm Saturdays. Tell renters to get their equipment returned by 2: 45 Sundays, and 830 Saturdays. Do not just leave rentals out. The renter is responsible for returning equipment. CHAPERONES MUST BE STAGGERED IN BUS. ONE IN FRONT, ONE IN THE MIDDLE, AND ONE IN FAR BACK NEXT TO THE RESTROOM. PLEASE chaperones should not be sleeping on the bus. Arriving at Gunstock: No one leaves the bus until they have a lift ticket on their jacket. Zip ties with tickets will be passed out upon arrival to leads by car chaps. Lead should report miscounts or extras to Mark. One chaperone should go out and help unload equipment while the others are passing out lift tickets. Make sure kids have taken their belongings with them, as the bus will be locked during the night. Allow students who are renting off the bus first. Rental chaperones will be waiting with signs to escort them to the rental areas. Throughout the day/night, chaperones must take walks around the lodge to curtail mischief. Chaperones need to keep an eye out on the lifts, slopes, and behind lodges for students who need assistance or are causing trouble.

6 *** THE BAR/LOUNGE AREA IS OFF-LIMITS TO CHAPERONES *** Loading bus at Gunstock: No kids on bus until chaperones are present, again not prior to 2:45 Sundays or 830 Saturdays. Same check-in procedure process applies as done in Londonderry check I.D. Do not check off anyone who is not physically present, even if you have heard they are not going home with us. You will be notified of anyone properly signed out. Arriving back in Londonderry: As we pass through the tollbooth in Hooksett, wake everyone up and remind kids to call home and get their rides heading to exit 4 so they are not late picking up. Collect trash. After the bus has emptied, chaperones should check for items left behind. Hold anything you find until the following week. Chaperones may not leave Park & Ride until all their kids have been picked up. SPECIAL SITUATIONS: Procedure for kids going up by car and back by bus: Parent must notify chaperone during the week. Chaperone notifies Lead. Lead s or calls Mark with info. Parent must be present to check kid in at Gunstock, with lodge chaperone not prior to 9am Sun, and 4pm Saturdays Ask parent to go to the Welcome Center/Guest Services and have Mark paged. This is the only way they can get their lift ticket for the day. They will be added to bus list by Mark. Procedure for kids getting ride up by bus and picked up by parent: Parent must notify chaperone during the week of intentions. Chaperone notifies lead, and lead s or calls Mark with info. Only a parent or designated adult with proper ID may pick up a child (no older siblings). Parent must write a note if another adult will be picking up their child. Give note to Mark. Adults signing out children will be asked to present a photo I.D. They may find Mark in the lodge or have him paged from the Welcome Center, prior to 3pm Sunday or 830 Saturdays. They will be taken off bus list by Mark Kids getting ride up and back by car: Parent must notify chaperone during the week. Chaperone notifies Lead. Lead s or calls Mark prior with info. Parent must be present to check kid in at Gunstock, not prior to 9am Sun., and 4pm Saturdays. Ask parent to go to the Welcome Center/Guest Services and have Mark paged. This is the only way they can get their lift ticket for the day. They will not show on any bus list.

7 Procedure for buses breaking down: Do not leave the bus until directed to by Mark. Each chaperone will be asked to move with their group to another bus if necessary. Other issues: Lead chaperone should bring the following each week: clipboard, 2 bus number signs, tape, trash bags, and pencils. Only G and PG rated movies allowed. Chaperones need to check their daily before and during the season for updates/notices from Mark. Chaperones who will be absent must notify their Lead and Mark as soon as possible so that alternate arrangements can be made. Car Chaperone responsibilities: Car chaperones play a vital role in the success of the program. They have no direct kid responsibility however they are needed to get to the mountain before buses arrive for ticket distribution and expediting kids through the rental process. They also help and instruct the newbies how to get their gear on. They are free to ski after the initial process but need to be available at anytime for sick or medical transports to either home or a local hospital. We have a call system in place at the mountain where car chaperones are notified if needed. Mark Hamilton, Chief / Lonskiclub@aol.com

8 Londonderry Ski Club 2014 Rules and Guidelines **Mix Night/Day Program** **Helmets are Mandatory for participants under 18 yrs. old** **New Sick Trick Lesson Program for Advanced Skiers/Riders Only** Trip Dates: January 11(Sat), 18 (Sat), 25 (Sat), February 2 (Sun), 9 (Sun) 1. Participants are to be at the exit 4 Park & Ride by 6:45 am for Sunday trips for a 715 departure. 145pm for 215pm departure on Saturday trips. This allows us time to take attendance prior to departure. 2. Parents are to be at the Park & Ride by 4:30 pm on Sundays. And 1015pm on Saturday nights. Participants not picked 4:45 pm on Sundays or 1030 on Saturday nights may not be able to attend the next week. 3. High School and Middle School age participants need their school ID, NH license, or a parent to vouch for them in order to board buses in Londonderry and at Gunstock. No exceptions! There is no switching of buses after seats are assigned. 4. Participants need to have their name on all equipment. They should also bring extra socks, gloves, etc. and most importantly a watch! 5. Helmets are mandatory for participants under 18. Anyone in this category that is caught not wearing a helmet on the mountain while skiing or riding will be suspended 1 week. A 2 nd offense will result in expulsion from the program, and their parents will be called to come pick them up. 6. Participants are not to be in possession of any illegal drug or use tobacco related products. Anyone possessing, using, or under the influence of alcohol or any illegal drug will be expelled from the program. Parents will be called to personally pick up their child at Gunstock if this occurs. 7. Theft, destructive or unsafe behavior at any time is not acceptable and will be grounds for prosecution and expulsion from the program. Offensive language will not be tolerated. 8. No refunds are given except for ski/snowboard injury incurred at Gunstock and reported to Safety Services the same night. A doctor s note must be submitted within one (1) week of injury and the refund will be granted for only the Gunstock portion of the program. Refund checks are requested through the Ski Club Director and administered through Gunstock at the end of the winter season. Please refer to the refund policy. 9. Participants are not allowed to drive themselves to or back from Gunstock. They are not allowed to be dropped off or picked up without authorization from the Ski Club Director in advance. If your child will be getting a ride up and/or ride home, parents must call their chaperone for instructions. This is the only way the participant can receive a lift ticket at the mountain. 10. Parents must contact chaperone if their child is unable to attend for any reason on a scheduled week for accountability purposes. No-shows that do not call their chaperones may be suspended for one week. 11. Skis and snowboards are NEVER allowed in the lodges. Remind your child to use the Free Ski/Board Check when not skiing/riding. This will help prevent stolen equipment. The Londonderry Ski Club and Gunstock are not liable for lost or stolen equipment. It is imperative that you mark your equipment somehow/someway with a permanent ID, spot or mark. 12. We strongly suggest that participants use ski lockers or baskets for their personal belongings. Baskets are Free!! 13. Participants should bring something to eat and money ($10.00) for the café. The average cost of a meal is $ Participants are not allowed on the bus at any time without a chaperone present. Buses are locked after we arrive at the mountain, so nothing should be left on the bus. 15. Participants need to be back on the bus by 3:00 pm Sundays and 845pm on Saturday night. Buses depart promptly at 3:15 pm on Sundays and 9pm Saturdays after attendance is taken. Anyone late for the bus without a justified reason may not attend the following week. 16. Ski/snowboard lessons are at 11:00 on Sundays and 530pm Saturdays Participants who are signed up are expected to attend and attendance will be taken by the chaperones. The ski school is located at the bottom of the mountain where the Mountain Magic flags are. Participants need to stand next to the flag that corresponds to their level. An instructor from Gunstock will meet them and assign instructors accordingly. 17. Participants who are renting equipment will be let off the bus first upon arrival after receiving their lift ticket. They are to immediately go to the front of their respective bus and line up with their group. Rental chaperones will escort them to the rental shops. This will be the same process every week. Rental equipment must be returned by 2:45 pm on Sundays. 18. No equipment is to be left out due to possible theft. Leaving equipment out is done at owner/renter risk. 19. If a participant has any problem or question at the mountain, they can go to the Welcome Center/Guest Services and request that the Ski Director be paged. Chaperones are also all over the mountain and in the lodges wearing orange armbands for easy identification. 20. Injuries occurring at the mountain should be reported to Safety Services the same day. Injuries that are not reported but result in the participant missing one or more weeks will not be considered under the Refund Policy. 21. Any participant not complying with the rules and guidelines will be subject to exclusion from the program at the discretion of the Director. Parents are asked to review all of the above with their child. 22. A $25 charge will be assessed on all late registrations after 11/18/11, and on any returned checks in addition to bank charges. 23. Any questions or concerns may be addressed to Mark Hamilton at Lonskiclub@aol.com or by vm at x6504 Note: You will be contacted prior to the program by your child s chaperone. They will be reviewing the above rules and guidelines with you. Parents are requested to write down their child s bus number, chaperone name and phone number.