70+ Val Gardena/Portugal This form is to make a deposit for the 2019 70+ Ski Europe trip. You will receive an invoice requesting a second deposit on 9/1 and final payment 11/1. Please contact the club if you need the trip flyer with all the trip details or have any questions. How many people is this deposit for?12Total $0.00 Are you a club member?*Family members and friends of members are welcome to participate!YesNoName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country PhoneEmail* Date of Birth 2nd Person Name and Date of BirthName* First Last Date of Birth* Additional InformationPlease select room assignmentPlease assign a roommateI prefer my own room and will pay single supplementPlease assign my preferred roommate (list name in comment section)Bed Preference(Subject to availability)1 bed (King or Queen)2 beds (doubles or queens)I understand cancellation policy*Fully refundable until 9/15. 9/16-10/11 Forfeit $100 per person. 10/12-12/1 50% penalty. No refunds after Dec 1. No shows are non-refundable. Charges for cancellations depend on the date that the written notice of cancellation is received in our office. YesNoIs this your first 70+ trip?YesNoHow will you arrive?*I will meet group at JFK NYLand Only - I will make my own air arrangementsPlease quote me air from where I live. (Please list preferred airport in comment section)Please select your preferred level(s) of skiing Non-skier Easy Groomed trails (slow pace) Intermediate groomed trails (moderate pace) Intermediate & Advanced trails (moderate to fast pace) Don't even try to keep up! (moguls and glades) I agree to waiver*I understand and am aware that skiing is a HAZARDOUS activity. I understand that the sport of skiing, travel to and from the ski area and other activities with the 70+ Ski Club involve a risk of injury to all parts of my body. I hereby agree to freely and expressly assume all risks of injury while skiing, travel to and from the ski area and activities with the 70+ Ski Club. I agree that I will release the 70+ Ski Club and its officers from any and all responsibility for injuries or damages to me or to any other person. I have carefully read this agreement and release of liability and fully understand its contents. I am aware that this is a rule of liability and a contract between me and the 70+.YesNoEmergency Contact (Name and Phone Number)*Please list name(s) and phone # (s) for an emergency point of contact.Comments / MessagePlease list any special requests including food restrictions, preferred roommates, or air connection requirements.CAPTCHA70 Plus Ski Club will process your payment through PayPal. You can either pay using a major credit card or by using your PayPal account. Thank you for joining us!