Student Enrollment Application We want to understand our student’s ability and any medical needs before they arrive. Please fill out the information below. Thank you. Today's Date MM slash DD slash YYYY Lesson Dates Student's Name First Last Phone NumberEmail Address Address City, State, Zip Code Age Sex Height Weight Shoe Size Check One Ski Today Snowboard Today Scholarship Requested Parent/Contact Person Phone Number Medical InformationDiagnosis*Description of DisabilityDescription of DisabilitySeizures Yes No Date of Last Seizure Type Medications Yes No Type AffectsPermanent conditions or medical apparatus we should be aware ofIf paralysis, where on spine: If head injury, explainActivities, sports, hobbies:Reinforcers/Triggers for behaviorOther information we need to knowDoctor/Therapist Phone Skier/Snowboarder Information Never-Ever Skied/Snowboard Before Number of Tiimes Where? Boots Skis/Snowboard Helmet Safety First: Everyone 17 years of age and younger must wear a helmet. If you have had a seizure within the past two years, you must wear a safety harness.Student Release Form Release: I recognize that skiing is a dangerous sport and accept the risks that are inherent in skiing and/or snowboarding and the ski area/mountain environment. I accept my responsibilities to be informed, to behave prudently, to abide by the Skier’s Responsibility Code and all other posted behavior notices and to ski safely and in control at all times. In consideration of acceptance of my enrollment in the All Season Adaptive Sports (SAAS), I release SADSP and Ski Apache Ski Resort and their employees, volunteers, representatives, and appointed personnel from all claims, liabilities, or costs, which occur from injury or death while skiing with the All Season Adaptive Sports.Student Name Signature Parent or Legal Guardian Must Sign if Student is Under 18Parent/Guardian Signature Because adaptive skiing is of public interest, representatives from the media often visit to obtain stories. This form gives permission for you or your child to be photographed if involved in a newsworthy event at Ski Apache Resort. I hereby grant permission for the taking of pictures and/or the release of general information regarding:Student Name City and State Age Photographs and/or general information may be published in, or used by, any of the media or mass communication (including newspapers, magazines, television, pamphlets, brochures, reports, etc.) without liability on the part of the agents, volunteers, or employees of Ski Apache Resort or the Ski Apache Adaptive Sports (SAAS). Δ