70+ Ski Utah Feb 26- Mar 5, 2022 This form is to make a deposit for the 70+ Ski Utah trip. 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?* 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 AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Date of Birth MM slash DD slash YYYY Phone2nd Person Name and Date of BirthName* First Last Date of Birth* MM slash DD slash YYYY Please choose your rooming situation.You can make any special requests, such as your preferred roommate, in the comments section at the end of this form. All suites also have an outer room with a pullout sofa. Please assign a roommate (2 queen beds in room) I prefer a single room and will pay supplement (1 King bed) Please choose your rooming situation.You can make any special requests, such as your preferred roommate, in the comments section at the end of this form. All suites also have an outer room with a pullout sofa. 2 double beds 1 King bed 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). Trip insurance if recommended. If the entire event is cancelled due to COVID-19, every effort will be made to provide a 100% refund. Yes No How will you arrive? by Air by Auto 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 Group Lift tickets - Skier #1In order to save everyone time and money, group lift tickets will be purchased for the group at certain resorts. The final price will be set in the Fall and will be included in the final invoice. The price will be based on your age and should be the lowest price option available. Unused tickets should be fully refundable. (For example, you take day off.) Please list any resorts below you will NOT need a ticket because you have a season pass. I have NO season passes with benefits in Utah I have an IKON pass I have an EPIC Pass with benefits at Park City, but not Snowbasin I have an EPIC Pass with benefits at Park City AND Snowbasin I have a Mountain Collective pass My pass listed above is Military I'm a non-skier or need no tickets Group Lift tickets - Skier #2In order to save everyone time and money, group lift tickets will be purchased for the group at certain resorts. The final price will be set in the Fall and will be included in the final invoice. The price will be based on your age and should be the lowest price option available. Unused tickets should be fully refundable. (For example, you take day off.) Please list any resorts below you will NOT need a ticket because you have a season pass. I have NO season passes with benefits in Utah I have an IKON pass I have an EPIC Pass with benefits at Park City, but not Snowbasin I have an EPIC Pass with benefits at Park City AND Snowbasin I have a Mountain Collective pass My pass listed above is Military I'm a non-skier or need no tickets 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 American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name Δ
