70+ Vermont Ski Fest Jan 2-6, 2023 This form is to make a deposit for the 70+ Vermont Ski Fest at Okemo. The form will display the total trip cost, but will only collect a deposit. Please contact us if you need the trip flyer with all the trip details or have any questions. How many people is this deposit for?* 1 2 Are you a club member?*Family members and friends of members are welcome to participate! Yes No Name* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail* Date of Birth MM slash DD slash YYYY 2nd Person Name and Date of BirthName* First Last Date of Birth* MM slash DD slash YYYY Lodging Choice (Guest #1)*Please choose your rooming situation. Inn rooms typically have 2 queen beds. Studio units either have (1) fixed or Murphy style queen sized bed and a sleeper sofa. Studios typically have a fireplace and full kitchen. Please assign a roommate (Inn Room 2 Queen Beds) I prefer a single ($+365) Me and my roommate prefer a Studio ($+25) Lodging Choice (Guests #1 & 2)*Please choose your rooming situation. Please select a room type. Inn rooms typically have 2 queen beds. Studio units either have (1) fixed or murphy style queen sized bed and a sleeper sofa. Studios typically have a fireplace and full kitchen. Inn Room Studio (+$50) Lift ticket Skier #1? (estimated cost - final price announced in the Fall)*Skiers typically choose 3-day tickets unless they plan to ski on the day of departure or have extended their stay. Tickets start Monday. 80+ EPIC Northeast Value passes for $39 are available for a limited time. Call 970-754-0004 for more information. These group prices ARE ONLY AVAILABLE BY PRE-PURCHASE, not at the window. 3 out of 4-days 4 out of 5 days I have an EPIC pass. Non-Skier Lift ticket Skier #2? (estimated cost - final price announced in the Fall)*Skiers typically choose 3-day tickets unless they plan to ski on the day of departure or have extended their stay. Tickets start Monday. 80+ EPIC Northeast Value passes for $39 are available for a limited time. Call 970-754-0004 for more information. These group prices ARE ONLY AVAILABLE BY PRE-PURCHASE, not at the window. 3 out of 4-days 4 out of 5 days I have an EPIC pass Non-skier Total $0.00 Additional InformationI understand cancellation policy*Cancellation policy: More than 120 days from start of trip (full refund), 60-119 days (forfeit deposit), 45-60 days (forfeit 75%), less than 45 days (no refund). Yes No 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*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 understand the risks associated with COVID-19. 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, illness, 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+ Ski Club. Yes No Emergency 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 any food restrictions, or preferred roommatesCAPTCHACredit Card (**only the deposit will be charged, but the form shows the total trip cost**) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name Δ
