DENVILLE RECREATION 2014 SKI & SNOWBOARD PROGRAM

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1 Registration for the Denville Recreation Ski and Snowboard Program is now open. The bottom of this form should be completed for each participant and returned to Don Bogardus, Denville s Recreation Director, as soon as possible. Registration received after December 13th may not be honored. The program will be held at Shawnee Mountain Pennsylvania, on Saturday s beginning January 4 February 8, 2014 (6 weeks). Any cancellations that may occur will be made-up at the conclusion of the scheduled program. Information about weather-related cancellations will usually be available on the Recreation Department s voic and s. Transportation will be provided by Vanderhoof Bus Co. Buses will depart from Town Hall at 3:30pm and return at 11pm each Saturday. Bus transportation is for the convenience of all participants and their families so please be on time dropping-off and picking-up your children. The program is open to all Denville residents; however, there are minimum age requirements for group lessons, 7 yrs. old for ski lessons; 8 yrs. old for snowboard lessons. Families with young children may prefer to drive to Shawnee- it s only an hour away. All are welcome to avail themselves to our discount rate. Anyone who registers by December 13th is guaranteed a spot. Registrations received after December 13th may be wait listed. Return this form to the Recreation Office as soon as possible. The Rec Office is located in Town Hall on the first floor. Questions may be directed to Don at , ext 238 or via at recreation@denvillenj.org One check, covering all family members, should be made payable to the Township of Denville Please circle the letter of the program desired: If you are not taking the bus, reduce fee by $ Please Note: prices below (left side) are for early registration (before Nov. 15 th ) if registration is received after Nov. 15 th please use the prices to the right. A lift tickets for skiing or snowboarding only $250 After Nov. 15 th $310 B lift tickets and 5 ski lessons $295 After Nov. 15 th $355 C lift tickets and 5 snowboard lessons $295 After Nov. 15 th $355 D lift tickets and ski rentals $305 After Nov. 15 th $360 E lift tickets, ski rentals and 5 ski lessons $345 After Nov. 15 th $405 F lift tickets and snowboard rentals $305 After Nov. 15 th $360 G lift tickets, board rentals and 5 snowboard lessons $345 After Nov. 15 th $405 Name: DOB Address: Home Phone Participant s Participant s Cell Phone Parent/Guardian s Emergency Cell Phone

2 DENVILLE RECREATION 2014 SKI/SNOWBOARD PROGRAM AGREEMENT TO PARTICIPATE Name Phone Address Birth Grade Beginner Intermediate Advanced ACKNOWLEDGEMENT OF RISK Please Read Carefully Covers Transportation to and from Ski Area, Ski/Snowboarding, Riding Chair Lift, or Other Ski/Snowboarding Related Accidents: I am aware that participating in this activity can be dangerous and involves risks of injury or loss. I realize that participating in the above mentioned program presents risks which include, but are not limited to serious neck and spinal injuries which may result in complete or partial paralysis, brain damage, serious injury to all internal organs, serious injury to virtually all bones, joints, ligaments, muscles, tendons and other aspects of my body, musculoskeletal system and serious injury or impairment to other aspects of my body, general health and well-being. Injuries may also be sustained as a result of running into other skiers, trees, or other objects on the side of the ski slopes, falling down or other skiing-related accidents. I understand that the dangers and risks of participating in the above activity may result not only in serious injury, but in serious impairment of my future abilities to earn a living, to engage in other business, social and recreational activities, and generally to enjoy life. Because of the possible dangers of participating in this activity, I recognize the importance of following the supervisors instructions regarding training and participating techniques. I agree to obey all instructions. While the possibility of serious injury to participants is unlikely, it is important that all participants realize that these risks do exist. The Denville Recreation Ski/Snowboard Program and Staff will take every reasonable precaution to insure that a safe, wholesome environment will exist. I am in proper physical condition for safe participation in the Denville Recreation Ski/Snowboard Program, and I agree that it is my duty to immediately inform the Denville Recreation Department if my physical condition changes prior to my participation in the program. I understand the specific risks associated with the program, and I certify that my parent/guardian has reviewed these risks with me and has explained them to me. Participant s Signature I have reviewed the above-mentioned risks with my child, and I allow him/her to participate in the Denville Recreation Ski/Snowboard Program. Parent/Guardian Signature I understand this participation agreement covers the 2009 Ski/Snowboarding Season.

3 EMERGENY MEDICAL RELEASE FORM Please Print Information Clearly: Participants Name Home Phone # Address of Birth Age Sex Grade Mother s Name Work # Cell # Father s Name Work # Cell # Guardian s Name Work # Cell# Doctor s Name Office # In Case of an emergency, if parents, guardian or doctor cannot be reached, call: Name: Phone # Health Ins. Co. Policy # of last Tetanus Shot Restricted activities, if any Medications currently being taken Allergies or reactions Recent illness, injury or surgery Note any physical or mental conditions to be aware of in case of an emergency Other Comments In case of an emergency, if no one mentioned above can be reached by telephone, I hereby give permission to the Denville Recreation Ski/Snowboard Program Staff and chaperones, and to the emergency personnel called upon to secure proper treatment for and to order injections, anesthesia, or surgery for my child if it is determined to be necessary. Parent or Guardian s Signature

4 PARENT/GUARDIAN/SELF AGREEMENT I hereby give my son/daughter/self my approval for his/her participation in any and all Ski/Snowboard trips. I recognize and acknowledge that there are certain risks of physical injury inherent in the named minor s participant in this program. I have received, read and understand the risks and have discussed them with my child. He/she understands that he/she must obey all rules and regulations, follow all safety procedures, and obey any and all instructors, assistant instructors, staff members and volunteers assigned to the program. My child and I understand the risks associated with the program and my child and I have agreed to accept our responsibility in making this program a safe one. I certify that the minor is in proper physical condition for safe participation in the Denville Recreation Ski/Snowboard Program, and I agree that it is incumbent upon me to immediately inform the Denville Recreation Department should the minor s physical condition change at any time prior to or during his/her participation in the program. In consideration of the Denville Recreation Department permitting the named minor to participate in the Denville Recreation Ski/Snowboard Program, the undersigned, parent/guardian, hereby waives and relinquishes all claims and hereby covenants and agrees to indemnify, defend and hold the Denville Township Recreation Department and the Township of Denville and their officers, employees and agents harmless of and from any and all claims, demands, losses, expenses, attorney fees, causes of actions, judgments, lawsuits, proceedings, damages and liability of any kind which are brought or claimed by anyone and which relate in any way to, or arise in any way from the participation of the above named Participant in the Ski/Snowboard Program. I understand that accidental medical insurance is not available through the program and it is my responsibility to arrange for such coverage for my son/daughter. I also give the Denville Recreation Ski/Snowboard Program; its organizers, supervisors and chaperones, permission to take my child for emergency treatment, if needed. Participants Name (please print) Parent/Guardian Name (please print) Parent or Guardian (indicate which) Signature Participants Signature Phone #

5 Rules: NO SMOKING or CHEWING TOBACCO allowed on the Bus NO DRUGS or ALCOHOL allowed on ANY TRIP NO PROFANE LANGUAGE NO THROWING ANY OBJECTS ON THE BUS NO STANDING UP ON BUS WHILE BUS IS MOVING NO SITTING ON ARMS OF SEATS, Everyone must have their own seat NO WEAPONS OF ANY KIND. (Including box cutters, pocket knifes, etc. NO LITTERING ON THE BUS, USE GARBAGE BAGS PROVIDED NO PUSHING, SHOVING, HITTING or YELLING while on the bus NO SKIING OUT OF BOUNDS or ON CLOSED TRAILS RESPECT YOUR CHAPERONES AT ALL TIMES RESPECT YOUR FELLOW SKIERS and SNOWBOARDERS AT ALL TIMES YOU MUST PROMPTLY BOARD THE BUS AT THE END OF THE EVEINING AT THE TIME SPECIFIED, or YOU WILL NOT BE ALLOWED TO ATTEND THE NEXT SKI TRIP. NO REFUNDS WILL BE ALLOWED. If any of the rules are broken, you shall be immediately terminated from all future ski/snowboard program trips without a refund. Depending on the severity of the violation, you may not be allowed to participate in any future Denville Recreation sponsored programs as determined by the Recreation Department. I have read and understand all the rules provided to me. I also understand that if I am in violation of any said rules, I can be terminated from the ski/snowboard program without refund, and may be banned from future ski/snowboard program trips as well as other Recreation Programs, as determined by the Recreation Department. Participants Signature I have reviewed all the rules with my child. I understand that if my child is in violation of said rules, he/she can be terminated from the ski/snowboard program, as well as other Recreation Programs, as determined by the Recreation Department. Parent/Guardian Signature