Registration Form Part 1

Please provide the requested information below for each participant. Fields marked with an *asterisk are required.

*Please choose the program:

There are currently no camps available for registration.

Note: These camps are for ages 18 and older.

Participant Profile

*Participant's First Name *Last Name *Street Address *City *State      *Zip Code

*Home Phone Local Phone *Participant's E-mail *Gender M    F *Participant's Date of Birth Month Jan Feb Mar April May June July Aug Sept Oct Nov Dec / Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Year

Medical Release

I, (*Participant) give permission to Hunter Mountain Ski Patrol or any other medical personnel to treat me in the event of a medical emergency or illness. I understand that every attempt will be made to reach my Emergency Contact as soon as possible.

*I agree to the terms of the above Medical Release

Medical Information

Is there any medical information we should know about the participant? Enter "none" if there are none known.

*Allergies

*Medications

*Physical

Emergency Contact Information

*Emergency Contact Name

Telephones:

*Home

Local

Work

Cell