Blandford's Snowsports Education Center
"Print & Mail" application
>> Please complete all 3 pages <<

Print & Mail all 3 pages to: BLANDFORD SKI AREA
PO Box 158 - 41 Nye Brook Rd. Blandford, MA 01008

Name:_________________________________________________

Age as of 12/31/06:_____Date of Birth: ________ Male: __ Female __

Street Address:_______________________________________

City:________________________ State:_____ Zip:___________

Parent(s) Name:_______________________________________

Phone:_________________ Cell Phone:_____________________

Email Address:__________________________________________


Program Fees: Register early - space limited in some programs
(Please check program choice)

Developmental Program

  • $250 by 11/30/07

  • $300 12/1/07 until opening day

  • Daily Cost $45

Adult Development Program

  • $200 by 11/30/07

  • $230 12/1/07 until opening day

  • Daily Cost $50

Ladies Mornings on the Mountain:

  • Lift/Lesson/Rental $245

  • Lift/Lesson             195

  • Lesson Only           110

Blandford's 5 Week Ski & Ride Program - Friday Nights (Space limited, reg. early)

  • Lift ticket only                 $ 60

  • Lift/Lesson                       155

  • Lift/Lesson/Rental             205

  • Lesson (SSC members)      95

  • Lesson Rental (members)  145

  • Lift/Rental                         110


 

Blandford's 5 Week Ski & Ride Program- Saturday or Sunday

  • Lift ticket only                 $110

  • Lift/Lesson                       205

  • Lift/Lesson/Rental             255

  • Lesson (SSC members)      95

  • Lesson Rental (members)  145

  • Lift/Rental                         160

 

Print and Mail along with appropriate fees to:

Blandford Ski Area
PO Box 158

Blandford, MA 01008

Attn: Snow-Sports Programs

Please make check out to Springfield Ski Club

Blandford Ski Area Snowsports Education Center
EMERGENCY MEDICAL CARE CONSENT

 

Name____________________________________ Date of Birth_______________

I authorize the Blandford Ski Club to seek emergency medical care if needed for my child.

Child’s Physician___________________________________________________________

Address___________________________________________________________________

Phone # _________________________________________________________________

Child’s Allergies ____________________________________________________________

Childs Chronic Health Condition ________________________________________________

Medications_______________________________________________________________

 

Emergency Contacts (in case parents are unable to be reached).
 Name___________________________________________ Relationship_____________

Address__________________________________________ Phone #_______________

Do you give permission for you child to be released to this person? Yes____ No___

Name____________________________________________Relationship_____________

Address__________________________________________ Phone #_______________

Do you give permission for you child to be released to this person? Yes____ No____

 

Insurance Information

Name: ____________________________________

Health Insurance Coverage_______________________________ Policy #_____________

Father _______________________________________ Home Phone _______________

Cell Phone ____________________

Mother ______________________________________ Home Phone _______________

Cell Phone ____________________

 

________________________________________ _____________________

Parent/Guardian Signature                                           Date

 

 

Blandford Snow-Sports Programs

Consent to Participate Form

 

Name : _______________________________

I give my approval / consent for the participation of my son / daughter in Blandford Snowsports Programs. I am aware of the risks and hazards incidental to such participation and I certify that he / she is physically fit to take part in all activities. I will not hold program authorities, staff or Springfield Ski Club or the Blandford Ski Area responsible in the case of accident or injury as the result of his / her participation. Permission is granted for the applicant to be given treatment by Ski patrol or at a local hospital and I will assume all responsibility for payment to said institution. I also grant program literature or publicity to promote said ski team. I pledge his / her compliance to all program rules and understand that should he / she be dismissed from a Blandford snowsports program for any conduct not in the best interest of the program. No part of the registration fee will be refunded.

 

_________________________________________ _______________________

Parent / Guardian Signature                                        Date

 

Skiers are occasionally photographed and video taped. Do you give permission for Blandford Ski Area to use these on their website or for other promotional purposes.

Yes: _____ No: _______

 

_________________________________________ _______________________

Parent / Guardian Signature                                      Date