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A SNOW LIFE EXPRESS Trip to CATALOOCHEE will take place Sunday Feb 9th . Departing 5:45am from Dick's Sporting Goods on Roswell Road in East Cobb. Chaperones include PE Dept members from Dickerson and Dodgen Middle School. Returning there around 8:30pm
First Name
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Last Name
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Sex
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M
F
Shoe Size
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Age
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Grade
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1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Sport/Activity
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Ski
Snowboard
Experience past 2 yrs
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None
1-2 days
3-4 days
5 or more
N/A
Sibling or other Family Participant
Last Name
Sex
M
F
Shoe Size
Age
Grade
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Sport/Activity
Ski
Snowboard
Experience past 2 years
None
1-2 days
3-4 days
5 or more
N/A
Enter Quantity/Program Selections
Ski/Snowboard Skills Program N/a
Cataloochee Day Trip FEB 9.........$129
Winter Games Adventure Package N/A
Cataloochee Day Trip FEB 9 without equip or you were on the Jan 2020 MBCA TRIP $119
SSSS Program Options ON CAMPUS LESSONS
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Not taking SSSS on Campus(EXPERIENCE REQUIRED)
PM After School Option
Current Total includes 3% Tax:
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Parent/Guardian INFO
Relationship to Participants:
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Self
Mother
Father
Guardian
Other
Other
First Name
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Last Name
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Additional Parent/Guardian Name
Address 1
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Address 2
City
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State
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Zip
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Phone
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Alternate Phone
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Email Address
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I under that there is risk of injury to myself or my child/ren from the activities involved in these programs. Including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 1) FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my child's participation; and, 2) I willingly agree to comply with the program's stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child's readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention of the nearest official immediately; and, 3) I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Southern School of Snow Sports LLC and the Host School, County School System in which the school exists, or Host Organization or property ; Its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my child's involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. 4) I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, and by completing the registration AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
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Contribution to PREvent DEfense Student Addiction Prevention Programs(not taxed)
Current Total Includes 3% Tax
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